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Evidence summaries

Clinical Findings in the Diagnosis of Compartment Syndrome of the Lower Leg

Clinical findings appear to have a low positive predictive value in the diagnosis of compartment syndrome of the lower leg. Level of evidence: "B"

A systematic review 1 including 4 studies with a total of 132 subjects was abstracted in DARE. The specificity of clinical findings for diagnosing compartment syndrome was low (13 to 19%). The positive predictive values (PPV) of clinical findings were 11 to 15%, while the sensitivity and negative predictive values (NPV) were both 97% to 98%. The probability of compartment syndrome was between 19 and 26% with one clinical finding; 68% with pain and pain with passive stretch; 93% with pain, pain with passive stretch, and paresis; and 98% with all four clinical signs.

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison).

References

  • Ulmer T. The clinical diagnosis of compartment syndrome of the lower leg: are clinical findings predictive of the disorder? J Orthop Trauma 2002 Sep;16(8):572-7. [PubMed] [DARE]

Primary/Secondary Keywords