A delay in the diagnosis of acute compartment syndrome (ACS) is associated with a potentially devastating outcome for the patient. A key risk factor for ACS is youth, with more than two-thirds of cases associated with an underlying fracture. Pain is noted as the index or key sign associated with ACS. However, clinical assessment alone has been documented to have poor diagnostic performance characteristics, with the sensitivity quoted in the literature 13–54%. Although combining symptoms and signs can improve the sensitivity, this will often mean irreversible disability has developed e.g. paralysis. Intracompartmental pressure monitoring of at risk patients has recently been found to have a high sensitivity (94%) and specificity (98%) when utilising a slit catheter technique and a differential pressure threshold of 30 mmHg for more than two hours.
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