Abstract
Acute compartment syndrome (ACS) is a surgical emergency and time-sensitive situation that might lead to permanent nerve and muscle damage, amputation of limbs, and systemic complications when timely diagnosis is not done. ACS is usually linked with high-energy traumas, but it might also present itself in minor injuries or unusual symptoms that make it difficult to recognize. This systematic review aimed to investigate the outcomes of delay in ACS diagnosis in the emergency department with regard to complication rates, functional outcomes, and early detection measures. Case control, retrospective, and prospective studies published between the years 2021 and 2025 were searched through a comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar. The research considered studies involving patients of any age with ACS and reported timing of diagnosis, intervention, and outcomes. Extraction of data involved time to diagnosis, fasciotomy timing, complications, hospital stay, and recovery of functions. Seven articles involving 336 participants were reviewed. Avoided complications such as neurological deficits, contractures, and infection, as well as extended hospitalization, were always linked with delays in diagnosis. Timely fasciotomy and recognition led to a major enhancement of functional recovery and a decrease in morbidity. The new strategies that boosted initial identification and intervention involved intra-compartmental pressure monitoring, laboratory markers, and risk stratification guidelines. Clinical vigilance, objective monitoring, and multifactorial assessment are important to minimize delays, complications, and improve outcomes in ACS. More studies are needed for the standardization of early diagnosis procedures and treatment plans.

Key words: Acute compartment syndrome, delayed diagnosis, fasciotomy, intracompartmental pressure, functional outcomes, musculoskeletal emergencies, systematic review