The following mechanism is not a recognised cause of compartment syndrome:
Giant lipoma. This is not a recognised cause of compartment syndrome. Compartment syndrome can be caused by increased interstitial volume or decreased compartmental space. All the options listed except lipoma are recognised causes due to an increased interstitial pressure - as are haemorrhage, and severe burns. Everyday exercise activities can very rarely also cause compartment syndrome which is well documented in the literature. A decrease in compartment size can also be due to burns, as well as the use of cast splints, prolonged lying on a limb and use of military anti-shock trousers (MAST).
References: 1. Broughton, G II. Compartment syndrome. In: Essentials of plastic surgery handbook: a UT Southwestern Medical Center handbook. Janis JE. St. Louis, USA: Quality Medical Publishing Inc., 2007: 634.
The following is the best indication for lower limb fasciotomy:
Full thickness electrical burn to the left leg of 12% body surface area. Homan’s sign was described in the context of deep venous thrombosis and has been largely discredited due to poor specificity and sensitivity as a clinical sign. Compartment pressure monitoring is controversial and the leg has four compartments that can have variable pressures in each. A high index of suspicion in the context of history and clinical examination in the scenario of an electrical injury of this nature would warrant fasciotomy.
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