Acute compartment syndrome is a true orthopaedic emergency where early recognition of raised compartment pressure and timely fasciotomy make all the difference. In this in-depth masterclass, we cover everything from the critical six-hour window to the subtle early signs of ischaemia. ⏱ Chapters 0:00 Intro 0:25 Essentials 1:08 Classification 1:51 Anatomy 2:25 Ps 3:01 Adsl 3:37 Cast 4:12 Delta 4:54 Algorithm 5:41 Technique 6:28 Numbers 6:59 Clinical reasoning — Delta 7:30 Clinical reasoning — Pearls This comprehensive video explores the pathophysiology, clinical diagnosisand surgical management of acute compartment syndrome across all major anatomical regions. We delve into the critical pressure thresholds, the progressive 'six P's' clinical signsand the regional fasciotomy techniques required to prevent irreversible muscle necrosis and devastating contractures. 🦴 IN THIS VIDEO YOU'LL LEARN • How to diagnose acute compartment syndrome clinically without delaying fasciotomy for pressure measurement • The critical pressure thresholds for fasciotomy, including absolute pressure over 30mmHg and delta P under 30 • Why tibial shaft fractures are the most common cause and how ischaemia-reperfusion injury contributes • The six P's of compartment syndrome and why pain on passive stretch is the most sensitive early sign • How to identify and release the deep posterior compartment of the leg to avoid incomplete fasciotomy • The regional anatomy of the leg, forearm, thigh, handand foot compartments • Why a palpable pulse does not rule out compartment syndrome due to its microvascular nature • How to stage severity from impending to established or necrotic compartment syndrome • The devastating consequences of delayed diagnosis, including Volkmann's ischaemic contracture ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Acute compartment syndrome is a clinical diagnosis; never delay fasciotomy for pressure readings if suspicion is high. ✔️ Fasciotomy within six hours offers the best outcomes; irreversible muscle necrosis begins after eight hours. ✔️ Pain out of proportion to the injury and pain on passive stretch are the earliest and most reliable indicators. ✔️ The deep posterior compartment is the most commonly missed structure during a leg fasciotomy. ✔️ Pulses remain palpable until extremely late because compartment syndrome is a microvascular problem. ✔️ Always remove tight casts or dressings immediately if compartment syndrome is suspected. 👩⚕️ WHO THIS IS FOR This masterclass is essential viewing for orthopaedic trainees, junior doctorsand medical students. It also provides valuable insights for clinicians managing acute trauma and curious patients wanting to understand this limb-threatening surgical emergency. 📚 RELATED TOPICS: Fasciotomy surgical techniques and incisions · Volkmann's ischaemic contracture pathophysiology · Tibial shaft fracture complications and management · Chronic exertional compartment syndrome · Crush syndrome and ischaemia-reperfusion injury 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #compartmentSyndrome #orthopaedics #fasciotomy #trauma #orthopaedicsurgery #orthopaedicemergency #acutecompartmentsyndrome #surgicaleducation #medicalstudent #tibialfracture #clinicalsigns