Compartment syndrome in the upper extremity.

It has been the purpose of this article to assist us in our approach to compartment problems, for, although a full-blown compartment syndrome following forearm injury is statistically uncommon, the results of this ischemic process can be devastating. A compartment pressure of greater than 30 mmHg for eight hours or more can cause cell death by interference with the microcirculation. Clinical diagnosis is made on the basis of a number of modalities, especially pain and paresthesias. Peripheral pulses or capillary flow are not specific indicators of compartment well-being. Direct compartment pressure measurements can be an invaluable tool but must be used in conjunction with the trend of the clinical findings. Limb elevation is not assistive in reducing compartment pressure, although removal of circumferential dressings and maintenance of mean arterial pressure can be. Prompt surgical decompression of the compromised compartment is the treatment of choice.