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Compartment syndrome is the compression of nerves and blood vessels within an enclosed space. This leads to muscle and nerve damage and problems with blood flow.
Causes, incidence, and risk factorsThick layers of tissue, called fascia, separate groups of muscles in the arms and legs from each other. Inside each layer of fascia is a confined space, called a compartment, that includes the muscle tissue, nerves, and blood vessels. Fascia surrounds these structures much like insulation covers wires.
Fascia do not expand, so any swelling in a compartment will lead to increasing pressure in that area, which will push on the muscles, blood vessels, and nerves. If this pressure is high enough, blood flow to the compartment will be blocked, which can lead to permanent injury to the muscle and nerves. If the pressure lasts long enough, the limb may die and need to be amputated.
Swelling leading to compartment syndrome is associated with trauma such as from a car accident or crush injury, or surgery. Compartment syndrome may also occur if you wear a bandage or a cast that is too tight.
Long-term (chronic) compartment syndrome can be caused by repetitive activities, such as running, which increase the pressure in a compartment only during that activity.
Compartment syndrome is most common in the lower leg and forearm, although it can also occur in the hand, foot, thigh, and upper arm.
SymptomsThe hallmark symptom of compartment syndrome is severe pain that does not go away when you take pain medicine or raise the affected area. In more advanced cases, symptoms may include:
- Decreased sensation
- Paleness of skin
- Weakness
A physical exam will reveal:
- Severe pain when moving the affected area (for example, a person with compartment syndrome in the foot or lower leg will experience severe pain when moving the toes up and down)
- Tensely swollen and shiny skin
- Pain when the compartment is squeezed
Confirming the diagnosis involves directly measuring the pressure in the compartment. This is done using a needle attached to a pressure meter into the compartment. The needle is inserted into the affected area. Compartment syndrome is diagnosed if the pressure is greater than 45 mmHg or when the pressure is within 30 mmHg of the diastolic blood pressure (the lower number of the blood pressure).
When chronic compartment syndrome is suspected, this test must be performed immediately after the activity that causes pain.
TreatmentSurgery is usually required. Long surgical cuts are made in the fascia to relieve the pressure. The wounds are generally left open (covered with a sterile dressing) and closed during a second surgery, usually 48 - 72 hours later. Skin grafts may be required to close the wound.
If a cast or bandage is causing the problem, the dressing should be loosened or cut down to relieve the pressure.
Expectations (prognosis)With prompt diagnosis and treatment, the outlook is excellent for recovery of the muscles and nerves inside the compartment. However, the overall prognosis will be determined by the injury leading to the syndrome.
Permanent nerve injury and loss of muscle function can result if the diagnosis is delayed. This is more common when the injured person is unconscious or heavily sedated and cannot complain of pain. Permanent nerve injury can occur after 12 - 24 hours of compression.
ComplicationsComplications include permanent injury to nerves and muscles that can dramatically impair function. (See: Volkmann's ischemia)
In more severe cases, amputation may be required.
Calling your health care providerCall your health care provider if you have had an injury and have severe swelling or pain that does not improve with pain medications.
PreventionThere is probably no way to prevent this condition, however, early diagnosis and treatment will help prevent many of the complications.
Persons with casts need to be made aware of the risk of swelling and should see their health care provider or go to the emergency room if pain under the cast increases despite pain medicines and raising the area.
ReferencesGeiderman JM. General principles of orthopedic injuries. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St Philadelphia, Pa: Mosby Elsevier; 2006:chap 46.
What else can I help you with?
What is the medical term meaning surgical treatment of compartment syndrome?
Fasciotomy is the medical term meaning surgical treatment of compartment syndrome.
What is compartment syndrome?
Compartment syndrome occurs when excessive pressure builds up inside an enclosed space in the body. Compartment syndrome usually results from bleeding or swelling after an injury. The high pressure impedes the flow of blood to and from the affected tissues and could be an emergency requiring immediate surgery.
Do you elevate an arm with compartment syndrome?
No, elevating an arm with compartment syndrome can exacerbate symptoms by increasing pressure within the affected compartment. Medical attention should be sought promptly to prevent complications and to relieve the pressure through surgical intervention if necessary.
Where could one find a symptoms list for Compartment Syndrome?
Compartment syndrome is a condition which occurs after an injury. Information about this condition can be obtained online at: The EMT Spot, Web MD and Global Genes.
Is compartment syndrome hereditary?
Compartment syndrome is not typically considered to be hereditary. It is more commonly associated with acute trauma or overuse injuries that lead to increased pressure within a muscle compartment, restricting blood flow and potentially causing damage to tissues. Genetics may play a role in an individual's susceptibility to certain conditions that can contribute to compartment syndrome, but it is not considered a directly hereditary condition.
What is acute compartment syndrome?
Compartment syndrome occurs when excessive pressure builds up inside an enclosed space in the body. Compartment syndrome usually results from bleeding or swelling after an injury. The high pressure impedes the flow of blood to and from the affected tissues and could be an emergency requiring immediate surgery.
What causes compartment syndrome?
Fat People With Dee Pum Pum Fat Enough
What does it mean to univalve a cast?
reducing pressure in a tight cast potentially resulting in compartment syndrome.
What syndrome involves the compression of nerves and blood vessels due to swelling within the enclosed space created by the fascia that separates groups of muscles?
This is referred to as a compartment syndrome.compartment syndrome
How long does it take for CK levels to rise in compartment syndrome?
In compartment syndrome, creatine kinase (CK) levels typically begin to rise within 4 to 6 hours of muscle injury due to ischemia. However, significant increases may not be seen until 12 to 24 hours after the onset of symptoms. The rate and magnitude of CK elevation can vary depending on the severity and duration of the ischemia. Monitoring CK levels is important for diagnosing and assessing the severity of compartment syndrome.
What is the average settlement lawsuit compartment syndrome?
There are a lot of different factors that can be associated with a high pay value for the plaintiff, ie time between the onset of compartment syndrome to time of the facsiatomy the more time the higher pay hopefully its a large avg settlement because iam in a lawsuit for misdiagnosis of acs as well
How would a nurse assess for compartment syndrome?
Compartment Syndrome typically involves individuals who have had an injury protected with a cast. Nurses would look for burning, itching, numbness, checking the area above and below the cast for +3 or +4 edema, ask about pain level, check capillary refill, check the temperature of the distal portion of the limb as well as checking pulse points when and where possible. It is EXTREMELY important that if it is suspected that a patient is suffering from compartment syndrome that the nurse should immediately notify the attending physician so that proper steps can be taken.
