Patients at risk for compartmental syndromes challenge both the
diagnostic and the therapeutic abilities of the physician. Suboptimum
results may be due to delays in diagnosis and treatment, to incomplete
surgical decompression, and to difficulties in the management of the limb
after decompression. Although careful clinical assessment permits the
diagnosis of a compartmental syndrome in most patients, we have found
measurement of tissue pressure and direct nerve stimulation to be helpful
for resolving ambiguous or equivocal cases. In our experience, the
four-compartment parafibular approach to the leg and the ulnar approach to
the volar compartments of the forearm provide efficient and complete
decompression of potentially involved compartments. The skeletal
stabilization of fractures associated with compartmental syndromes may
facilitate management of the limb after surgical decompression.