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This chapter discusses the diagnosis, evaluation and management of compartment syndrome. In trauma, the anterior compartment of the leg is the most common location of compartment syndrome; however, it is possible for it to occur in any extremity compartment. Symptoms commonly arise within 2 hours of injury but can also present up to 6 days later. The additional findings of paresthesias, anesthesia, paralysis, poikilothermia, and pulselessness are very late findings and should not be relied upon in the initial evaluation of compartment syndrome. The treatment of compartment syndrome is immediate relief of the pressure and this starts with removing any constricting devices, bandages or casts. Surgical intervention is the definitive treatment in which complete fasciotomy is performed in the operating room (OR) by trauma, vascular, or orthopedic surgeons. Neutral elevation is the preferred position. Raising the limb above the heart decreases perfusion without decreasing compartment pressures.
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