Acute Extremity Compartment Syndrome Research Articles

The effect of time from injury to fasciotomy in patients with acute upper extremity compartment syndrome.

Acute compartment syndrome of the upper extremity is a surgical emergency, and timely diagnosis with immediate fasciotomies is essential for the preservation of function. This retrospective study aimed to compare the complication rates of patients who underwent fasciotomy before and after 6 hours following the initial trauma. The medical records of the patients who underwent fasciotomy for surgical treatment of ACS of the upper extremity between 2016 and 2022 were retrospectively analyzed for age, gender, dominant hand, mechanism of injury, injury level, affected compartments, associated injuries, time elapsed till fasciotomy, and complications. The patients were divided into two groups according to the timing of fasciotomy. A total of 32 patients underwent fasciotomies for upper extremity ACS. The mean age of patients who underwent fasciotomy ≤ 6 hours (group 1; 10 males, 7 females) and patients who underwent fasciotomy > 6 hours (group 2; 13 males, 2 females) was 31.1 and 34.8, respectively. The most common etiology was crushing injury. There was a significant difference in complication rates between group 1 (1/17) and group 2 (10/15) (p<0.001). The length of hospitalization stay in group 2 was statistically higher than in group 1 (p=0.005). Fasciotomies for ACS of the upper extremity should be performed in less than 6 hours following the initial trauma to prevent complications.

Analysis of acute extremity compartment syndrome using a genealogic population database.

Acute extremity compartment syndrome ("CS") is an under-researched, highly morbid condition affecting trauma populations. The purpose of this study was to analyze incidence rates and risk factors for extremity compartment syndrome using a high-quality population database. Additionally, we evaluated heritable risk for CS using available genealogic data. We hypothesized that diagnosis of extremity compartment syndrome would demonstrate heritability. Adult patients with fractures of the tibia, femur, and upper extremity were retrospectively identified by ICD-9, ICD-10, and CPT codes from 1996 to 2020 in a statewide hospital database. Exposed and unexposed cohorts were created based on a diagnosis of CS. Available demographic data were analyzed to determine risk factors for compartment syndrome using logistic regression. Mortality risk at the final follow-up was evaluated using Cox proportional hazard modeling. Patients with a diagnosis of CS were matched with those without a diagnosis for heritability analysis. Of 158,624 fractures, 931 patients were diagnosed with CS. Incidence of CS was 0.59% (tibia 0.83%, femur 0.31%, upper extremity 0.27%). Male sex (78.1% vs. 46.4%; p < 0.001; RR = 3.24), younger age at fracture (38.8 vs. 48.0years; p < 0.001; RR = 0.74), Medicaid enrollment (13.2% vs. 9.3%; p < 0.001; RR = 1.58), and smoking (41.1% vs. 31.1%; p < 0.001; RR 1.67) were significant risk factors for CS. CS was associated with mortality (RR 1.61, p < 0.001) at mean follow-up 8.9years in the CS cohort. No significant heritable risk was found for diagnosis of CS. Without isolating high-risk fractures, rates of CS are lower than previously reported in the literature. Male sex, younger age, smoking, and Medicaid enrollment were independent risk factors for CS. CS increased mortality risk at long-term follow-up. No heritable risk was found for CS. III.

Pro-Con Debate: Peripheral Nerve Blockade Should Be Provided Routinely in Extremity Trauma, Including in Patients At Risk for Acute Compartment Syndrome.

In this Pro-Con commentary article, we discuss the controversial debate of whether to provide peripheral nerve blockade (PNB) to patients at risk of acute extremity compartment syndrome (ACS). Traditionally, most practitioners adopt the conservative approach and withhold regional anesthetics for fear of masking an ACS (Con). Recent case reports and new scientific theory, however, demonstrate that modified PNB can be safe and advantageous in these patients (Pro). This article elucidates the arguments based on a better understanding of relevant pathophysiology, neural pathways, personnel and institutional limitations, and PNB adaptations in these patients.

Prehospital management of earthquake crush injuries: A collective review.

Earthquakes are natural disasters which can destroy the rural and urban infrastructure causing a high toll of injuries and death without advanced notice. We aim to review the prehospital medical management of earthquake crush injuries in the field. PubMed was searched using general terms including rhabdomyolysis, crush injury, and earthquake in English language without time restriction. Selected articles were critically evaluated by three experts in disaster medicine, emergency medicine, and critical care. The medical response to earthquakes includes: (1) search and rescue; (2) triage and initial stabilization; (3) definitive care; and (4) evacuation. Long-term, continuous pressure on muscles causes crush injury. Ischemia-reperfusion injury following the relieving of muscle compression may cause metabolic changes and rhabdomyolysis depending on the time of extrication. Sodium and water enter the cell causing cell swelling and hypovolemia, while potassium and myoglobin are released into the circulation. This may cause sudden cardiac arrest, acute extremity compartment syndrome, and acute kidney injury. Recognizing these conditions and treating them timely and properly in the field will save many patients. Majority of emergency physicians who have worked in the field of the recent Kahramanmaraş 2023, Turkey, earthquakes, have acknowledged their lack of knowledge and experience in managing earthquake crush injuries. We hope that this collective review will cover the essential knowledge needed for properly managing seriously crushed injured patients in the earthquake field.

Early assessment of extremity compartment syndrome by biochemical markers in a rat model.

This experimental study aimed to define a biochemical marker that will enable early diagnosis of acute compartment syndrome (ACS) of extremities, a mortal condition that occurs due to trauma. A total of 15 Wistar rats were included in the study in which saline infusion technique, a clinically compatible ACS model, was applied. After the rats were anesthetized with ketamine-xylazine, the in-compartment pressure of the hind limb was slowly increased with saline delivered through the angiocatheter, and after reaching the target compartment pressure, the pressure level was kept with a rubber tourniquet. The in-compartment pressure level was continuously monitored with a pressure transducer. The rats were divided into three groups. No intervention was applied to the control group (CG) (n = 3). In study group 1 (SG1) (n = 6), ACS was created using the saline infusion technique, keeping the in-compartment pressure between 30 and 40 mmHg for 45 min. In study group 2 (SG2) (n = 6), ACS was created using the saline infusion technique, keeping the in-compartment pressure between 30 and 40 mmHg for 90 min. Fasciotomy was performed on all rats. Tissue samples were obtained for histopathological examination and blood samples for biochemical analysis. Total oxidant status (TOS) (p = 0.004), ischemia-modified albumin (IMA) (p = 0.030), aspartate transferase (AST) (p = 0.003) and neopterin (p = 0.012) levels differed significantly between groups in the early period of muscle ischemia. In fact, TOS levels differed significantly between the groups even in the cellular phase where signs of ischemia were not observed (p = 0.048, p = 0.024). According to histopathological evaluation, there was no significant difference between the groups. TOS can be detected in the early reversible stage of ischemia, when the histopathological findings of ACS do not occur.

Acute Extremity Compartment Syndrome and (Regional): Anesthesia: The Monster Under the Bed.

Acute compartment syndrome (ACS) is a potential orthopedic emergency that leads, without prompt diagnosis and immediate treatment with surgical fasciotomy, to permanent disability. The role of regional anesthesia (RA) for analgesia in patients at risk for ACS remains unjustifiably controversial. This critical review aims to improve the perception of the published literature to answer the question, whether RA techniques actually delay or may even help to hasten the diagnosis of ACS. According to literature, peripheral RA alone does not delay ACS diagnosis and surgical treatment. Only in 4 clinical cases, epidural analgesia was associated with delayed ACS diagnosis.

Impact of varying degrees of peripheral nerve blockade on experimental pressure and ischemic pain: adductor canal and sciatic nerve blocks in a human model of compartment syndrome pain

IntroductionEarly diagnosis of acute extremity compartment syndrome is crucial to timely surgical management. Pain is commonly used as an early diagnostic sign for acute extremity compartment syndrome, making regional anesthesia...

Extremity compartment syndrome: A review with a focus on non-invasive methods of diagnosis.

The article deals with an overview of acute extremity compartment syndrome with a focus on the option of non-invasive detection of the syndrome. Acute extremity compartment syndrome (ECS) is an urgent complication that occurs most often in fractures or high-energy injuries. There is still no reliable method for detecting ECS. The only objective measurement method used in clinical practice is an invasive measurement of intramuscular pressure (IMP). The purpose of this paper is to summarize the current state of research into non-invasive measurement methods that could allow simple and reliable continuous monitoring of patients at risk of developing ECS. Clinical trials are currently underway to verify the suitability of the most studied method, near-infrared spectroscopy (NIRS), which is a method for measuring the local oxygenation of muscle compartments. Less explored methods include the use of ultrasound, ultrasound elastography, bioimpedance measurements, and quantitative tissue hardness measurements. Finding a suitable method for continuous non-invasive monitoring of the syndrome would greatly improve the quality of care for patients at risk. ECS must be diagnosed quickly and accurately to prevent irreversible tissue damage that can occur within hours of syndrome onset and may even warrant amputation if neglected.

Acute shine compartment syndrome: epidemiology, etiology, pathophysiology, anatomy, diagnostics, treatment, complications and outputs: literature review

Vytautas Matiulevič1 1Vilnius University, Faculty of Medicine, Vilnius, Lithuania, Abstract Background. Compartment syndrome is an acute condition that requires urgent care. Patients with traumatic leg injuries need to be considerately monitored since complications associated with late diagnosis and treatment lead to irreversible consequences. Aim of the study. Summarize the latest studies and provide information on the relevance, clinical signs, diagnostic and treatment features of compartment syndrome. Materials and methods. The review of the literature was conducted using the PubMed, ScienceDirect, and ClinicalKey databases. The literature research was conducted using predetermined keywords: acute compartment syndrome, fasciotomy, diagnosis and treatment of compartment syndrome, acute extremity compartment syndrome. Exclusion criteria were applied to articles related to crush syndrome. More than 20 publications were analyzed. Results. Most of the clinical signs of compartment syndrome are nonspecific. Fasciotomy should be performed after suspicion of compartment syndrome and measuring the differential pressure < 30 mm Hg. Conclusions. The most common cause of calf compartment syndrome is tibial fractures. Patient complaints are nonspecific. Pain, non-manageable with NSAIDs, and muscle tension are usually present. Diagnosis is based on patient complaints, physical examination, and measurement of differential pressure. Fasciotomy is recommended when the differential pressure is < 30 mm Hg. This is the only effective treatment for compartment syndrome. There are 2 calf fasciotomy techniques: single incision and two incisions. The surgeon chooses the technique based on his experience and the condition of the patient as the results are similar. Untreated, patients develop soft tissue necrosis, resulting in muscle weakness, pain, nerve damage, cosmetic defects, and venous insufficiency. Keywords: acute compartment syndrome, fasciotomy, diagnosis, treatment.

Substance-Related Found-Down Compartment Syndrome: A Systematic Review.

To characterize the patient population with substance-related found-down extremity compartment syndrome (FDECS) and report on their treatment and outcome. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Articles in English language were identified by searching 3 online databases, EMBASE, PubMed Publisher, and Cochrane Central, in September 2019. Studies involving substance-related FDECS were included. Exclusion criteria were as follows: patient age <18 years, not original studies, no full text available, technical reports, traumatic acute extremity compartment syndrome, chronic exertional compartment syndrome, and vascular acute extremity compartment syndrome. There were 61 studies included with 166 cases of FDECS. Two investigators screened and extracted data independently according to a standardized template. Disagreements were addressed by an attempt to reach a consensus, and involvement of a third reviewer. Studies were quality assessed with "Quality Assessment tool for Case Series Studies." Descriptive statistics were reported using Excel. Substance-related FDECS is often occurring in young adults. Data from this review found that most of the patients were already diagnosed with substance use disorders and/or psychiatric disorders. There should be a high index of suspicion of FDECS in patients presenting after prolonged immobilization. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

PRESUMED CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME

SESSION TITLE: Fellows Critical Care Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: October 18-21, 2020 INTRODUCTION: Antiphospholipid antibodies (aPLs) are associated with recurrent early pregnancy loss and arterial as well as venous thrombosis. A small subset of patients develop a life-threatening form of the disease with widespread thrombosis and multiorgan failure, called catastrophic antiphospholipid syndrome (CAPS). CASE PRESENTATION: A 26-year-old female, 10 weeks pregnant, with a history of 2 prior miscarriages presented with hyperemesis gravidarum. She had a pulseless electrical activity cardiac arrest in the ER with return of spontaneous circulation after 15 minutes of advanced cardiovascular life support (ACLS). Left heart catheterization showed no evidence of coronary artery disease. Transthoracic echocardiogram showed preserved ejection fraction and no other abnormality. CT angiogram of the chest ruled out pulmonary emboli but showed diffuse bilateral airspace opacities, concerning for acute respiratory distress syndrome (ARDS). Patient developed acute kidney injury, acute right lower extremity arterial thrombosis and compartment syndrome requiring fasciotomy, upper extremities superficial venous thrombi, fetal loss and spontaneous abortion. Working diagnosis of CAPS was made; aPLs, anti-cardiolipin and anti-beta2 glycoprotien-1 antibodies levels ordered and patient started on IV heparin infusion, IV glucocorticoids and plasmapheresis followed by IV immunoglobulins (IVIG). Anticoagulation was held intermittently due to acutely worsening thrombocytopenia with low fibrinogen levels concerning for disseminated intravascular coagulation (DIC), and bleeding around the fasciotomy site, hematuria and vaginal bleeding (workup for heparin induced thrombocytopenia remained negative). Cryoprecipitate and blood transfusions were required. Acute respiratory failure resolved with low tidal volume ventilation, prone positioning and aggressive diuresis. Tissue biopsies for histopathology were deferred. Patient was discharged to inpatient rehab after prolonged hospital stay. DISCUSSION: Approximately 1% of antiphospholipid syndrome patients develop CAPS. Lungs are the second most common organs involved with ARDS being the most common complication. Mortality was 37% in a cohort of 500 patients. Management of CAPS includes aPL testing including lupus anticoagulant, antibeta-2 glycoprotein-1 and anticardiolipin antibodies without delaying empiric treatment. Combination therapy with glucocorticoid, heparin, and plasmapheresis or IVIG rather than single agents is recommended. CONCLUSIONS: Differential diagnosis of CAPS includes DIC which usually presents with small vessel thrombosis but has been reported to cause arterial thrombosis as well, and for which the patient was treated once the platelet counts dropped later. However, with the patient’s history and clinical presentation and given the high mortality rate, we decided to start aggressive empiric therapy after having sent aPL testing. Reference #1: Cervera R.: Antiphospholipid syndrome. Thromb. Res. 2017; 151: pp. S43-S47 Reference #2: Cervera R., Piette J.-C., Font J., Khamashta M.A., Shoenfeld Y., Camps M.T., et al: Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum. 2002; 46: pp. 1019-1027 Reference #3: Bucciarelli S., Espinosa G., Cervera R., Erkan D., Gómez-Puerta J.A., Ramos-Casals M., et al: Mortality in the catastrophic antiphospholipid syndrome: causes of death and prognostic factors in a series of 250 patients. Arthritis Rheum. 2006; 54: pp. 2568-2576 DISCLOSURES: No relevant relationships by Priyanka Bhat, source=Web Response no disclosure on file for Shafaq Ejaz; No relevant relationships by Ahmed Qadir, source=Web Response No relevant relationships by karan Singh, source=Web Response No relevant relationships by Rodney Steff, source=Web Response

Drug Overdose, Loss of Consciousness, and Compartment Syndrome: A Life-Threatening Combination

Acute extremity compartment syndrome is considered an orthopedic emergency that has serious consequences if a correct diagnosis is not made rapidly. Patients who lose consciousness due to a drug overdose are known to collapse onto their extremities. The limbs are compressed for hours, placing them at an increased risk for acute extremity compartment syndrome and its sequelae. Compartment syndrome due to a compression of a limb from loss of consciousness secondary to drug overdose, presents unique issues to health care providers. In the setting of overdose compartment syndrome, it is similar to the more common traumatic type of compartment syndrome with respect to the pathophysiology, diagnosis and treatment. However, it differs in relation to the muscles affected, physical assessment strategy, and accurately determining the amount of the time from onset of injury to the presentation of symptoms. The purpose of this article is to facilitate emergency department nurses' understanding of the complexities of overdose compartment syndrome, combined with the importance of early recognition of the condition. In addition, the authors review the pathophysiology, the traditional and innovative diagnostic techniques, and the current treatment options available for overdose compartment syndrome.

Life and Limb In-Flight Surgical Intervention: Fifteen Years of Experience by Joint Medical Augmentation Unit Surgical Resuscitation Teams.

Expedient resuscitation and emergent damage control interventions remain critical tools of modern combat casualty care. Although fortunately rare, the requirement for life and limb salvaging surgical intervention prior to arrival at traditional deployed medical treatment facilities may be required for the care of select casualties. The optimal employment of a surgical resuscitation team (SRT) may afford life and limb salvage in these unique situations. Fifteen years of after-action reports (AARs) from a highly specialized SRTs were reviewed. Patient demographics, specific details of encounter, team role, advanced emergent life and limb interventions, and outcomes were analyzed. Data from 317 casualties (312 human, five canines) over 15 years were reviewed. Among human casualties, 20 had no signs of life at intercept, with only one (5%) surviving to reach a Military Treatment Facility (MTF). Among the 292 casualties with signs of life at intercept, SRTs were employed in a variety of roles, including MTF augmentation (48.6%), as a transport capability from other aeromedical platforms, critical care transport (CCT) between MTFs (27.7%), or as an in-flight damage control capability directly to point of injury (POI) (18.2%). In the context of these roles, the SRT performed in-flight life and limb preserving surgery for nine patients. Procedures performed included resuscitative thoracotomy (7/9; 77.8%), damage control laparotomy (1/9; 11.1%) and extremity fasciotomy for acute lower extremity compartment syndrome (1/11; 11%). Survival following in-flight resuscitative thoracotomy was 33% (1/3) when signs of life (SOL) were absent at intercept and 75% (3/4) among patients who lost SOL during transport. In-flight surgery by a specifically trained and experienced SRT can salvage life and limb for casualties of major combat injury. Additional research is required to determine optimal SRT utilization in present and future conflicts.

Acute Extremity Compartment Syndrome and the Role of Fasciotomy in Extremity War Wounds.

Acute compartment syndrome (CS) is a frequent and potentially devastating complication of blunt and penetrating extremity injuries. Extremity war injuries are particularly susceptible to CS due to associated vascular injuries; high Injury Severity Score; extensive bone and soft tissue injury; and frequent transportation that may limit close monitoring of the injured extremity. Treatment consists of prompt fasciotomy of all compartments in the involved segment, over their full length. Delayed or incomplete fasciotomy is associated with worse outcomes, including muscle necrosis, infection, and amputation. Enhanced pre-deployment training of surgeons decreases the need for revision fasciotomy at higher echelons of care and should be continued in future conflicts. We recommend the liberal use of prophylactic fasciotomy prior to aeromedical evacuation and after limb reperfusion. For leg fasciotomy, we recommend a two-incision approach as it is more reproducible and allows easy vascular exposure when necessary.

Current diagnosis and treatment of acute extremity compartment syndrome

Extremity compartment syndrome can cause neuromuscular ischemia and deposition of metabolites in the compartment, leading to irreversible lesions which harm limb functions in the end. It is a great challenge for surgeons to make a timely and accurate diagnosis of the syndrome in adults and children. The key is evaluation of the clinical symptoms and intracompartmental pressure. In this paper we summarize the epidemiology, etiology, pathophysiology, and current diagnosis and treatment of acute extremity compartment syndrome of the upper and lower extremities in adults and children. Key words: Compartment syndromes; Diagnosis; Therapy; Measurement of pressure

Simulation education for lower limb fasciotomy: improving surgical trainee confidence in executing a time-critical limb-saving procedure.

Acute extremity compartment syndrome is a relatively rare but well-recognised complication seen in a wide variety of clinical situations from acute trauma to snakebites. Local swelling within a muscle compartment results in increasing tissue pressure resulting in critical ischaemia, severe pain and altered sensation. There is only one effective treatment and that is timely surgical decompression of the osteofascial compartments involved.1 Failure to do so results in crippling ischaemic muscle contractures and in extreme cases, death. The surgical treatment is technically simple, however the stumbling blocks to success lie in recognition along with the speed and completeness of the surgery. Each of the four osteofascial compartments in the leg (anterior, peroneal, deep and superficial posterior) must be fully decompressed.1 The development of the Management of Surgical Emergencies (MSE) course was supported by the Department for International Development with the International Federation of Surgical Colleges, Association of Surgeons of Great Britain and Ireland, and College of Surgeons of East, Central and Southern Africa.2 Following an initial pilot course, the need for integration of compartment syndrome education was identified by one of the authors (YN). In Africa, although a huge proportion of the clinical workload is obstetrics and general surgery, a surgeon is expected to deal with all conditions requiring surgery. There are parallels between this truly time-critical emergency and cardiac arrest for which simulation training is well established, as it is …

Open fracture of tibia mid-shaft associated with the contralateral leg acute compartment syndrome without fracture

The acute extremity compartment syndrome is caused by increased compartment volume or restriction of compartment size. There are 23% of all compartment syndrome is caused by isolated soft-tissue injury especially in crushing injury. We report a 30-year-old male with the initial diagnosis of the right tibia open fracture, Gustilo Type II, due to a motor-vehicle accident. Besides the right leg condition, he was continually suffered from left leg pain, where the X-ray revealed no apparent fracture since the collision. The physical examination showed no skin lesion and deformity; however, numbness and tightness were noted, toe stretching pain+, Pedis Dorsalis Artery+, Posterior Tibialis Artery+. Doppler showed the presence of PDA and PTA blood flow. Nine hours after the injury, pain and numbness of his left leg and foot still persisted and also pale and pulseless developed. Doppler for his left leg was done again and showed the negative result of PTA and PDA. Emergent bilateral side fasciotomy for his left leg was arranged, and the cardiovascular department was consulted for intraoperative angiography. The fasciotomy wound was cared with sterilized saline wet dressing for 3 days. Medial fasciotomy was closed with delayed primary method, and the lateral sides were treated with split-thickness skin graft. Acute compartment syndrome is diagnosed by the interpretation of a collection of clinical signs and symptoms. In a patient with a swollen limb, in the absence of a fracture and for whom, there is a suspicion of an acute compartment syndrome, methods, technology, and application for the early detection of acute compartment syndrome is important and also provides promising opportunities for the clinicians to perform early interventions.

Acute Compartment Syndrome of Upper Extremities with Tendon Ruptures.

It is well known that acute compartment syndrome is associated with fracture of the forearm, while involvement of soft tissue injury including musculotendinous injury remains unclear. The purpose of this study was to evaluate the soft tissue involvement, including musculotendinous ruptures, in acute compartment syndrome of the upper limb. We retrospectively enrolled 16 patients who underwent surgical treatment for acute compartment syndrome of the upper extremity. The average age of the patients was 47 years (range, 14 to 79) and the mean follow-up period after the surgery was 15 months (range, 12 to 29). Complications included at least one presentation at the final follow up of sensory disturbances or motor disturbances. We examined the presence of musculotendinous injury mechanism of injury, presence of fracture, the performance of skin grafting, and complications. Mechanism of injury of "caught in a machine" was found in six cases. Three of these patients had musculotendinous ruptures and all muscle tears were revealed by intraoperative findings. No patients had muscle ruptures with other injury mechanisms. Seven out of 16 patients (44%) developed complications at final follow-up. Skin grafting was performed in six patients, and five of these patients developed complications. Only one of the nine patients without complications underwent skin grafting. In cases of high-energy injuries, the surgeon should suspect the presence of a musculotendinous injury prior to surgery.

Acute Extremity Compartment Syndrome Secondary to Statin-Induced Myopathy

Acute Extremity Compartment Syndrome Secondary to Statin-Induced Myopathy

Prevalence and Predisposing Factors of Compartment Syndrome among Patients with Lower Limb Fracture at Assiut University Hospital

Compartment syndrome is a painful condition that most often occurs following trauma. The aim of the study was to identify the prevalence and predisposing factors of compartment syndrome among traumatic patients at Assiut University Hospital. Subjects and Method: This study was carried out in trauma unit at Assiut University Hospital. The study sample consisted of all patients with lower limb fractures admitted to trauma unit within 6 months period. The following tools were utilized for data collection: first tool Patient's interview questionnaire , second tool Patients' assessment for the presence of compartment syndrome, third tool Patients' assessment of risk factors sheet. Results: incidence of compartment syndrome among traumatic patients at Assiut University Hospital over six months period was 15 patients out of 217 lower limb fractured patients 6.9%. Regarding the predisposing factors, the highest percentage (53.3%) was related to crushing injury. Conclusion: The incidence of acute lower extremity compartment syndrome at Assiut University Hospital was 6.9%. High energy injuries such as road traffic accidents and fall from height as well as gun-shot injuries are the most predominant precursors for lower extremity compartment syndrome. Recommendations: Monitoring of intra compartmental pressure for patients having risk factor for developing compartment syndrome should be considered to allow for early detection and management.