By far the most frequent complications of compartment syndromes occur when there is a failure to diagnose and treat in a timely manner. Compartment pressure measurement is a safe procedure when performed with care, but complications can occur.

 

Infection

 

Vascular injury

 

Inaccurate readings

 

Iatrogenic pressure elevation

Infection

Any invasive procedure carries the risk of causing an infection that was previously absent. Theoretically, individuals with a compartment syndrome are at higher risk to develop serious infection because they already have impaired circulation. The use of sterile technique minimizes this risk. Prophylactic antibiotics should be given to anyone that has sustained open fractures.

vascular injury

Inadvertant injury to vascular structures during the procedure can be devastating to an individual with already elevated compartment pressures (especially in the presence of coagulopathy). Prior to performing the procedure, pertinent anatomy and standard approaches should always be reviewed. This is particularly important when measuring compartments where the density of vascular structures is high (such as the volar compartment of the forearm).

inaccurate pressure recordings

Failure to insert the needle or catheter properly into the substance of a compartment to be measured can lead to false positive and false negative results. Care should be taken to avoid insertion of the needle into tendons or intraosseus membranes. Please see the Methods section for a review of specific downfalls that may be associated with specific techniques.

iatrogenic compartment pressure elevation

Avoid injection of significant volumes of anesthetic into muscle compartments. Care should also be taken to minimize injection of saline into any given compartment, as significant infusions may further elevate compartment pressures. While very little data exists to quantitate these effects, one study reported that rapid injection of one cc saline into the anterior compartment of the lower leg raised compartment pressures by 1 mm Hg. 3 While this result is small, it may be clinically significant in borderline cases.

 

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