This is a prospective observational study of patients with suspected Acute Compartment Syndrome. The primary objective of this work is to determine whether intensity changes associated with the NIRST signal, reflecting oxy- and deoxy-hemaglobin and water concentrations or ICG fluorescence signal, reflecting tissue perfusion, can be associated with development of Acute Compartment Syndrome and identification of at-risk soft tissue and muscle.

Inclusion Criteria:

• Age 18 years or older

• Clinical suspicion of acute compartment syndrome based on orthopaedic provider assessment. Clinical suspicion would be based upon the presence of one or more of these findings:

  • Pain out of proportion to visible findings
  • Escalating doses of pain medication
  • Pain with passive stretch of toes and/or fingers
  • Pallor, paresthesias, pulselessness
  • Tense soft tissues
  • High energy tibia or forearm fracture

• Provision of informed consent

Exclusion Criteria:

• History of allergy to ICG and/or iodine
• Pregnant women or nursing mothers
• Any patient with an open wound for whom NIRST device cannot be applied >4cm from the open wound will be excluded from NIRST imaging.

Subjects receiving care at DHMC (Lebanon) with high energy lower leg or forearm trauma at risk for Acute Compartment Syndrome.