Compartment syndrome of limb

Q) All are true about compartment syndrome of limb except?

a) Diagnosis is unlikely if pulse is felt distally

b) There is pain on passive stretching of the limb

c) Pain is out of proportion to the signs

d) Muscles of calf and forearm are commonly involved


When hydrostatic pressure within a fascial compartment increases sufficiently it will compromise the effective circulation within the compartment leading to tissue ischemia and necrosis. Muscles of forearm, calf and, hand and foot are commonly involved.

Compartment syndrome is a clinical diagnosis characterised by pain out of proportion, increasing pain and pain on
passive stretch. Paralysis, paraesthesia and pallor are late signs
and pulselessness is an extremely late sign

Of note is that peripheral pulses are generally NOT affected and alteration in sensation is a late sign. There can be compartment syndrome and pulses may still be paalpable

Generally acceptedvpressure thresholds include an absolute pressure greater than
or equal to 30 mmHg or pressure difference (diastolic pressure – compartment pressure) less than or equal to 30 mmHg.

Ref: Bailey 26th 431 and updated from Bailey 27 page 408