Summary of Recommendations

Document Overview

Design and created by Guideline Central in participation with the American Academy of Orthopaedic Surgeons.

Management of Acute Compartment Syndrome

American Academy of Orthopaedic Surgeons

Publication Date: Nov 18, 2025

Page Last Updated: Jul 28, 2026

Interpreting the Strength of Evidence

Strength of Recommendation
Strength	Overall Strength of Evidence	Description of Evidence Quality
Strong	Strong	Evidence from two or more “High” quality studies with consistent findings for recommending for or against the intervention.
Moderate	Moderate	Evidence from two or more “Moderate” quality studies with consistent findings, or evidence from a single “High” quality study for recommending for or against the intervention.
Limited	Low Strength Evidence or Conflicting Evidence	Evidence from two or more “Low” quality studies with consistent findings or evidence from a single “Moderate” quality study recommending for against the intervention or diagnostic or the evidence is insufficient or conflicting and does not allow a recommendation for or against the intervention.
Consensus*	No Evidence	There is no supporting evidence. In the absence of reliable evidence, the guideline development group is making a recommendation based on their clinical opinion. Consensus statements are published in a separate, complimentary document.

Document Overview

Document Title: Management of Acute Compartment Syndrome

Authoring Society: American Academy of Orthopaedic Surgeons

Document Publication Date: Nov 18, 2025

Page Last Reviewed/Updated: Jul 28, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.aaos.org/globalassets/quality-and-practice-resources/acute-compartment-syndrome/2025-acs-rapid-update/acs-cpg-2025.pdf

Source Citation: American Academy of Orthopaedic Surgeons Management of Acute Compartment Syndrome Evidence-Based Clinical Practice Guideline. aaos.org/acs2025cpg Published 11/18/2025

Document Scope, Criteria, and Use Cases

Document Objectives: The purpose of this clinical practice guideline is to guide the clinician’s ability to diagnosis and treat acute compartment syndrome by providing evidence-based recommendations for key decisions that affect the management of patients with extremity trauma.

Scope: Assessment and Screening, Diagnosis, Management, Prevention, Rehabilitation, Treatment

Diseases/Conditions (MeSH): D003161 - Compartment Syndromes

Keywords: acute compartment syndrome, acute compartment syndrome (ACS)

Target Patient Population: Adult patients with acute compartment syndrome of traumatized extremities

Target Provider Population: Orthopaedic surgeons and other clinicians caring for acute compartment syndrome of traumatized extremities in adult patient

Inclusion Criteria: Male, Female, Adult, Older Adult

Health Care Settings: Ambulatory, Emergency Care, Hospital, Operating and Recovery Room, Outpatient

Intended Users: Nurse, Nurse Practitioner, Occupational Therapist, Physical Therapist, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Data Supplement

Number of Source Documents: 31

Includes peer/external review process?: Yes

Includes public comment process?: Yes

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Identifies study selection process?: Yes

Identifies study selection criteria?: Yes

Identifies methods used to evaluate and analyze the evidence?: Yes

Identifies key questions addressed by the systematic review?: Yes

Identifies search strategy?: Yes

Management of Acute Compartment Syndrome

Summary of Recommendations

Biomarkers

Serum Biomarkers in Late/Missed ACS

Pressure Methods

Pressure Monitoring in Late/Missed ACS

Physical Example (Awake)

Physical Exam (Obtunded)

Alternative Methods of Diagnosis

Fasciotomy Methods

Fasciotomy for Late/Missed ACS

Associated Fracture

Wound Management

Pain Management Effects on Diagnosis

Interpreting the Strength of Evidence

Document Overview

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology