Diagnosing Acute Compartment Syndrome

Are Current Textbooks Misleading?

Amir Oron, MD; Niv Netzer, MD; Philip Rosinsky, MD; Danielle Elmaliache; Peleg Ben-Galim, MD


Curr Orthop Pract. 2018;29(6):527-529. 

In This Article


Of 117 medical students and physicians who participated in the study, only 34 (29%) answered the question correctly, and 63 (53%) chose the answer presenting the "5 P"s (Figure 2). The participants included 64 medical students, 12 residents, and 41 nonorthopaedic physicians. Of the eleven nonorthopaedic classic textbooks that were reviewed, three[3–5] associated the classic "5 P" signs with the diagnosis of ACS, although also mentioning the essential elements of POP and PPS. These textbooks made note that pulselessness, paresthesia, and paralysis are signs that appear late in the course of the disease, but they do not emphasize that they should never be waited for because they appear in the terminal stage. Seven textbooks[11–17] made no mention at all of the potentially life and limb-saving diagnosis of ACS. Only one current classic medical textbook presents coherent diagnostic guidelines with no mention of the "5 P" signs[18] (Table 1).

Figure 2.

The distribution of survey answers shows that only 29% answered the question correctly and over half the participants chose the classic "5 P" signs.