Treatment

ACS is a surgical emergency and requires emergent fasciotomy, as irreversible tissue necrosis and functional impairment can occur within 4–6 hours of onset.

• Remove constrictive dressings, splints, and devices.

• Provide systemic analgesia.

• Place the limb at the level of the heart.

• Reduce displaced fractures.

• Administer supplemental oxygen.

• Indications: strongly suspected or confirmed acute compartment syndrome

• Techniques

  • Fasciotomy: incision(s) in the skin and fascia to relieve compartment pressure and restore perfusion

    • Perform emergently to prevent irreversible injury.

    • Postoperative wound treatment: usually left open for delayed primary closure

  • Escharotomy: incision of circumferential compressing burn eschar

  • Fibulectomy: removal of the fibula to decompress all four compartments of the leg