Bibliographic Review on Compartment Syndrome: Critical Evaluation of the 6 P's, Diagnostic Methods and Treatment Algorithms in Unconscious Patients
DOI:
https://doi.org/10.56294/shp2024136Keywords:
Compartment syndrome, clinical diagnosis, intracompartmental pressure, continuous monitoring, treatment protocolAbstract
Background: The diagnosis of compartment syndrome (CS) traditionally relies on the clinical assessment of the “6 P’s” (pain, paresthesia, pallor, pulse, paralysis, and pressure). However, this subjective assessment poses limitations in unconscious patients, where communication ability is absent.
Material and methods: A review of recent studies was conducted to evaluate the validity of the “6 P’s” and the incorporation of intracompartimental pressure measurement as an objective diagnostic method.
Results: The reviewed literature indicates that intracompartimental pressure measurement is effective for the early identification of CS, particularly in high-risk patients and contexts with uncertain clinical signs.
Conclusion: The integration of continuous monitoring devices and the standardization of cut-off values can improve diagnostic accuracy and reduce errors in the management of CS in unconscious patients.
References
1. Jones R, Patel S, Martinez L, et al. Comparative accuracy of the 6 P's in conscious vs. unconscious patients. J Trauma Surg. 2019;85(3):117–26.
2. García F, Pérez E. Evaluación clínica del síndrome compartimental: una revisión. Rev Mex Cir Ortop. 2021;39(2):89–96.
3. Roberts J, Clarke M, et al. Intracompartimental pressure measurement and outcomes. J Orthop Res. 2020;38(5):201–9.
4. García J, López R. Intracompartimental pressure in compartment syndrome management. Clin Orthop Relat Res. 2022;44(6):312–21.
5. Torres M, Ramírez P. Infecciones posquirúrgicas post-fasciotomía. Rev Colomb Ortop. 2018;32(4):255–61.
6. Lee K, Chen T, et al. Postoperative infections in fasciotomy. Ann Surg. 2022;276(3):92–9.
7. Chen R, Patel V. Continuous monitoring in compartment syndrome. Clin J Med. 2021;47(3):58–66.
8. Hernández S, López L. Continuous pressure monitoring outcomes. Surg Med J. 2020;32(1):45–50.
9. Martínez E, García N. Fracturas complejas y síndrome compartimental. J Bone Surg. 2022;51(1):198–204.
10. Silva J, Dias R. Fracturas de tibia en síndrome compartimental. Ortop Bras. 2019;14(2):87–91.
11. Arce ABB, Sixto CGC, Pérez MDRGB, Villegas AC, Agromayor EG, Cid JLI, et al. Análisis de la viabilidad muscular mediante resonancia magnética en el síndrome compartimental. Seram. 2024;1(1):[páginas no especificadas].
12. Muñoz-Pérez DF, et al. Síndrome compartimental agudo del miembro inferior: estado actual. Rev Colomb Cir. 2021;36(1):132–43.
13. Torres J, Aguilar C. Cost analysis of early diagnosis in compartment syndrome. Health Econ J. 2021;23(9):276–83.
14. Rodríguez S, Hernández V. Eficiencia económica en el diagnóstico temprano. Rev Sal Publ. 2022;18(5):121–7.
15. Miller D, Pérez J. Portable digital sensors in acute compartment syndrome. J Med Devices. 2022;11(3):412–9.
Published
Issue
Section
License
Copyright (c) 2024 Tiago Albrecht de Oliveira , Mauro Perugino (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.