American Board of Internal Medicine (ABIM) Certification Practice Exam

What intracompartment pressure indicates the need for fasciotomy?

1. 25 mm Hg

2. 30 mm Hg

3. 35 mm Hg

4. 40 mm Hg

The correct answer is: 30 mm Hg

Fasciotomy is a surgical procedure required to relieve pressure in cases of acute compartment syndrome, which can occur after trauma, fractures, or various medical conditions that lead to increased pressure within a muscle compartment. The threshold for indicating a fasciotomy is generally considered to be a compartment pressure of 30 mm Hg or higher. At this pressure, the microcirculation is compromised, leading to a risk of muscle and nerve damage. Delayed intervention can result in irreversible complications, including muscle necrosis and permanent functional loss. Therefore, if measured intracompartment pressure reaches 30 mm Hg, it signals the urgency of performing a fasciotomy to prevent further damage and preserve limb function. Higher pressures, such as 35 mm Hg or 40 mm Hg, are clearly critical, but the established cutoff for taking action is around 30 mm Hg. This emphasizes the importance of early recognition and intervention in cases of compartment syndrome.