Compartment Syndrome & Neurovascular Emergencies

Acute compartment syndrome occurs when pressure builds inside a closed muscle compartment (from swelling, bleeding, or a constrictive cast/dressing) faster than the tissue can accommodate, cutting off perfusion to the muscles and nerves inside — it's a true surgical emergency, since irreversible muscle and nerve damage can begin within as little as 6 hours if untreated. The earliest and most reliable warning sign is pain that is out of proportion to the injury and pain with passive stretch of the affected muscles — this typically appears well before pulselessness, which is a late and ominous finding, not an early warning sign to wait for.