**Author details**

**5. Complications of musculoskeletal injury**

deformity and limb viability may possibly be lost.

A prolonged elevation of interstitial tissue pressure within an enclosed fascial compartment leading to impaired tissue perfusion and damage. Associated with increased vessel permeability and plasma leak into the intercellular space causing further pressure on muscles and

This serious and critical musculoskeletal complication can be caused by direct blow or contusion, crush injury, burns, snake bites, fractures, hematoma, and prolonged pressure from

It is characterized by severe pain especially with stretching, tense compartment, tight and shiny skin. Late findings can be paresthesia, loss of pulses, and pain out of proportion.

It should be noted that any case with prolonged ACS of more than 8–12 h can have permanent

During management, every effort should be used to release all compartments; the main focus is on reducing the dangerous pressure in the body compartment. Dressings, casts, or splints that are constricting the affected body part must be removed. Early recognition and diagnosis, pain control, keeping the body part with ACS below the level of the heart (to improve blood flow into the compartment), treatment of shock, prevention of metabolic acidosis and acute

The incidence and socioeconomic impact of musculoskeletal diseases globally is increasing due to multiple factors. Prevention of these injuries can be achieved by providing an environment in which the worker has a safe surrounding, improved awareness about what possible danger injuries might occur, a clear path to elevation of such danger in the time of need. Occupational safety measures should always be optimal with nearby kits to aid in on-site management. With the increased demand for building and aiming to touch the clouds with sky-high skyscrapers comes great responsibility to care more about providing a healthy working environment. The frequency of musculoskeletal injury and its concomitant burden on the healthcare system is expected to increase greatly in the coming decades. Physicians are required to keep up with this leap. A well-established basic knowledge of such injuries is very crucial and can be lifesaving and cost-effective especially in the emergency department. The previous injuries we discussed are not by any chance everything in the musculoskeletal system; we chose the most common and the most essential ones, discussed briefly. We

nerves (**Figure 25**); it might result in death if not treated before 8–12 h [14–18].

Treatment of ACS is urgent surgical exploration with fasciotomy (**Figure 26**).

kidney injury (AKI) are all mandatory and crucial to save the patient limb [18–20].

**5.1. Acute compartment syndrome (ACS)**

190 Essentials of Accident and Emergency Medicine

splinting.

*5.1.1. Management of ACS*

**6. Conclusion**

Ahmad Subhy Alsheikhly<sup>1</sup> \* and Mazin Subhy Alsheikhly2

