Current Treatment on Compartment Syndrome of the Hand

Abstract

Compartment syndrome is a critical condition characterized by elevated pressures within constricted myofascial compartments, leading to vascular compromise, hypoxia, and potential irreversible injury. While commonly affecting the forearm and lower leg, compartment syndrome of the hand is rare and poses unique diagnostic and therapeutic challenges. The pathophysiology involves increased intracompartmental pressure from various etiologies, such as trauma, edema, or external compression, culminating in a cycle of ischemia and worsening edema. Rhabdomyolysis, defined by rapid muscle tissue degradation and release of intracellular components into the bloodstream, is intricately linked to compartment syndrome, with each condition potentially exacerbating the other. Elevated serum creatine kinase and myoglobin levels are hallmark diagnostic markers of rhabdomyolysis.

Hand compartment syndrome, despite its rarity, necessitates prompt identification and surgical intervention. The hand's complex anatomical structure comprises ten compartments, each at risk for ischemic injury under increased pressure. Clinically, hand compartment syndrome manifests as severe pain disproportionate to injury, edema, and abnormal posturing. Diagnosis relies on clinical suspicion, supported by intracompartmental pressure monitoring. Emergent fasciotomy remains the definitive treatment, requiring multiple incisions to decompress affected compartments. Magnetic resonance imaging (MRI) is valuable for assessing tissue damage and guiding management strategies. This review underscores the importance of early recognition and timely intervention in compartment syndrome and highlights the interdependent relationship between compartment syndrome and rhabdomyolysis.