Compartment syndrome

Abstract

A compartment syndrome exists when the interstitial tissue pressure within an osteofascial envelope rises to non-physiologic levels and, when sustained, can lead to irreversible changes in the contents of the compartment. Compartment syndrome of the upper extremity may evolve from many different causes, traumatic and nontraumatic, and often involves a complex decision-making process regarding its diagnosis and management, particularly in the pediatric patient. While rare, neonatal upper extremity compartment syndrome should be considered in the presence of distal limb ischemia, skin blistering, and swelling at birth. The consequences of compartment syndrome are limb and life threatening, and it is critical for the clinician to recognize conditions with which it is associated and to understand the pertinent anatomy, the pathophysiology, and the treatment strategies. The purpose of this chapter is to review the nature of upper extremity compartment syndrome in the pediatric upper limb, to describe potential etiologies of the condition, and to review pertinent anatomy, pathophysiology, treatment recommendations, and outcomes of treatment for this challenging and emergent condition.