AAOS 2018 Guideline for Acute Compartment Syndrome
The American Academy of Orthopaedic Surgeons (AAOS) has released a new Clinical Practice Guideline (CPG) to help physicians develop their own evidence-based approach to diagnosing and treating adult patients with traumatic injuries at risk for acute compartment syndrome (ACS).

ACS usually develops after a severe injury, such as a car accident or broken bone. Swelling or bleeding can occur within a limb compartment containing muscles, nerves, and blood vessels. Disrupting the flow of blood, oxygen and nutrients to the arms, legs, hands, feet and buttocks can damage nerve and muscle cells. It also can cause permanent disability and tissue death.

“There is no strong literature to support any specific approach to the diagnosis and management of ACS. Clinicians need to remain vigilant for the onset of ACS in any patient presenting with limb swelling and be prepared to act immediately when the clinical situation demands,” said Dr. Andrew Schmidt Co-chair of the guideline workgroup. “In the absence of any sort of evidence-based standards, any and all clinical decisions regarding assessment and/or treatment of presumed ACS should be carefully documented in the patient’s medical record.”

The guideline highlights include the following:-

• Limited evidence for the effectiveness of a reliable clinical, physical exam; moderate evidence that continuous or repeated compartment pressure measurements assist in the diagnosis of ACS when using a perfusion pressure of less than 30 mmHg

• No evidence-based recommendations for any particular method of compartment pressure measurement. Laboratory biomarkers remain unproven in discerning ACS from other causes of muscle injury

• Fasciotomy, or surgical release of the involved compartments, needs to be done in a manner that results in complete decompression of the affected compartment.

• However, the guideline does not recommend performing fasciotomy in late-stage ACS when there is evidence of irreversible muscle and nerve damage in the extremity


About AAOS
With more than 38,000 members, the American Academy of Orthopaedic Surgeons (AAOS) is the world’s largest medical association of musculoskeletal specialists. The AAOS provides education programs for orthopaedic surgeons and allied health professionals, champions and advances the highest quality musculoskeletal care for patients, and is the authoritative source of information on bone and joint conditions, treatments and related issues.

Note: This list is a brief compilation of some of the key recommendations included in the Guidelines and is not exhaustive and does not constitute medical advice. Kindly refer to the original publication here: https://pxmd.co/4s177
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