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Compartment Syndrome - Pictures, Treatment, Causes, Surgery

Updated on December 4, 2013

Pictures

What is Compartment Syndrome?

This is a severe medical condition that affects your limbs. Limbs are a combination of nerves, muscles, and blood vessels and when you group them it can be thought of as compartments. The walls of these compartments are made of strong connective tissue called "fascia". When a person has compartment syndrome there is increased pressure in a muscle compartment.

This can lead to nerve and muscle damage. It can also lead to problems with the flow of your blood. It can be a very painful condition and can either be chronic or acute. It can also be a life- and limb-threatening condition. Compartment syndrome usually happens in your arms or legs but can happen in any space that is enclosed such as your foot, thigh, upper arm, or hand. It can affect anyone but is more common in athletes.

  • Acute compartment syndrome - this form is a medical emergency and is problem that is common.
  • Chronic compartment syndrome - this form is also known as exertional compartment syndrome. It is not a medical emergency and is uncommon.

Symptoms

The symptoms that a person has with compartment syndrome depend on which type they have. The pain that is associated with compartment syndrome usually does not go away even if you raise the area that is affected or you take medicine for the pain.

Acute compartment syndrome

This form can occur in your leg or arm and can develop quickly over hours or even days.

  • In the affected area there is swelling, usually severe.
  • Weakness in your limb muscles.
  • In the affected area you may notice a tingling or numbness sensation.
  • Pain that seems to get worse after the area that is affected has been worked on or stretched.
  • Having an absence of pulse
  • Paleness
  • The muscles may feel full or tight
  • Bruising

A late sign of compartment syndrome is having paralysis or numbness and this can indicate tissue injury that is permanent.

Chronic compartment syndrome

With this form it most often happens in your lower leg and can happen over days or weeks. The symptoms may disappear within minutes after you stop exercising and rest.

  • Having difficulty moving your foot.
  • Muscle bulging that is visible
  • Numbness, tingling sensation, or weakness.
  • Cramping, or pain along with a burning sensation when exercising and can be felt in your lower leg, buttock, or thigh muscles. This usually happens within thirty minutes after you begin to exercise.
  • Swelling

Causes

The tissue inside each compartment does not have enough room to stretch, which is called "inelastic". Compartment syndrome happens when certain factors cause the pressure inside a compartment to go to high levels that are abnormal. Because the fascia, or thick layer of connective tissue, cannot stretch it makes the pressure build up even higher. As a result, the blood vessels and nerves compress, resulting in the blood flow in your limbs to become impaired, causing the change of muscle and nerve damage to increase. The muscles may die if the pressure lasts too long, causing your leg or arm not to work any longer.

The exact cause of compartment syndrome depends on the type you have.

Acute compartment syndrome

This type is usually caused by some type of traumatic event such as an injury from a bite, burn, car crash, muscle tear, etc. Approximately three-fourths of the time, this type is caused by a broken arm or leg. It rarely happens after a minor injury

  • In a traumatic event it could be caused by soft tissue injuries or a complex fracture.
  • It can also happen because of surgery to the blood vessels of your leg or arm and the blood flow is reestablished after being blocked.
  • It can happen after having an injury without having any bone fractures.
  • Burns
  • Bandaging that is overly tight
  • Being unconsciousness for a period of time and having a compression of a limb during this time for a prolonged period of time.
  • Blood clot in the blood vessel of your leg or arm
  • A muscle that is badly bruised such as when a motorcycle falls on the rider’s leg.

Chronic compartment syndrome

This type is usually caused by vigorous exercise that is done on a regular basis or sports that have many repetitive movements such as running, swimming, or biking.

Treatment

Whatever treatment is done is necessary to reduce the dangerous pressure in the limb that is affected.

Acute compartment syndrome

Treatment for this type usually requires immediate surgery in order to relieve the pressure in the affected limb. If it is caused by a bandage or cast then they need to be cut down or loosed to relieve pressure. Other treatments may include:

  • Keeping the limb below the level of your heart to improve blood flow into the affected limb.
  • Getting fluids intravenously
  • Taking pain medications

Chronic compartment syndrome

The treatment for this type uses both surgical and conservative treatment. Some of the conservative treatments used include:

  • Pain and inflammatory medication
  • Strengthening and stretching exercises
  • Massage
  • Changes in activities
  • Physical therapy
  • Avoiding the activity that caused it.

Because these methods do not provide long term relief you may need surgery.

Surgery

The surgical treatment that is performed can be used for acute and chronic compartment syndrome. One thing to remember is that acute compartment syndrome is most often a surgical emergency and if it is not done it could result in permanent damage or even amputation of the affected limb. The surgical procedure is called "fasciotomy". During this procedure the surgeon will make an incision and cut open the skin that covers the affected area in order to let the compartment to expand because of the increase in pressure. If the swelling is extremely severe the surgeon may need to leave the incision open until the swelling goes down and it can be closed. If a second surgery is needed to close the incision it can usually be done within twenty-four to seventy-two hours later. Sometimes the surgeon may need to do a skin graft to close the incision or remove part of the tissue.

The one difference between the surgery that is done for acute or chronic compartment syndrome is the incision is shorter in the acute compartment syndrome surgery. The surgery for chronic compartment syndrome is usually an elective surgery.

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