Compartment Syndrome is a serious condition that occurs when there is increased pressure within a closed muscle compartment, compromising circulation and function of the tissues within that space. It can lead to muscle and nerve damage and, if left untreated, can cause permanent damage or loss of the affected limb.

Types of Compartment Syndrome:

Acute Compartment Syndrome: Typically caused by a severe injury, such as a fracture, crush injury, or severe bruising. It is a medical emergency.

Chronic Compartment Syndrome: Often occurs in athletes due to repetitive activities, like running or cycling. It is less urgent but still requires medical attention.

Common Symptoms

• Severe pain: Disproportionate to the injury, often worsening with movement.
• Tightness or swelling: In the affected area.
• Numbness or tingling: In the limb.
• Paleness or coolness: Of the skin in the affected area.
• Weakness or difficulty moving: The affected limb.

Cause & Anatomy

Acute Compartment Syndrome:

• Fractures
• Crush injuries
• Severe bruising or hematomas
• Tight bandages or casts
• Burns
• Reperfusion injury after restoring blood flow

Chronic Compartment Syndrome:

• Repetitive activities or exercises
• Muscle hypertrophy

Diagnosis

• Physical examination: Checking for pain, swelling, and tightness in the affected area.
• Pressure measurement: Using a compartment pressure monitor to measure the pressure within the muscle compartment.
• Imaging tests: MRI or ultrasound may be used to assess the condition and rule out other causes of symptoms.

Prevention

• Proper training: Gradual increase in activity intensity and duration.
• Stretching and strengthening: Regular exercises to improve muscle flexibility and strength.
• Protective gear: Proper use of padding and equipment to prevent injuries.
• Avoiding tight bandages or casts: Ensuring that any casts or bandages are not too tight and do not restrict blood flow.

Treatment

Acute Compartment Syndrome

• Immediate fasciotomy: Surgical procedure to relieve pressure by cutting open the fascia, preventing permanent damage to muscles and nerves.
• Supportive care: Pain management, fluid management, and monitoring for complications.

Chronic Compartment Syndrome

• Activity modification: Reducing or changing the activities that trigger symptoms.
• Physical therapy: Exercises to improve flexibility and strength.
• Non-surgical interventions: Anti-inflammatory medications, orthotics, and changes in footwear.
• Surgery: In severe cases, a fasciotomy may be necessary.

Rehabilitation

• Post-surgery: Physical therapy to restore function and strength.
• Gradual return to activity: Slowly reintroducing activities under medical guidance.
• Monitoring for recurrence: Regular follow-ups to check for any signs of returning symptoms.

FAQ’s

How serious is compartment syndrome?
Acute compartment syndrome is a medical emergency that requires immediate treatment to prevent permanent damage. Chronic compartment syndrome, while less urgent, still requires medical attention to manage symptoms and prevent long-term issues.

Can I prevent compartment syndrome?
While not all cases can be prevented, proper training, avoiding excessive repetitive activities, and using appropriate protective gear can reduce the risk.

What happens if acute compartment syndrome is not treated promptly?
Delayed treatment can lead to permanent muscle and nerve damage, and in severe cases, may necessitate amputation of the affected limb.

Can chronic compartment syndrome go away on its own?
Symptoms may improve with rest and activity modification, but persistent or severe cases often require medical intervention, including possible surgery.

Is surgery always required for compartment syndrome?
Surgery is typically required for acute compartment syndrome. Chronic cases may be managed with non-surgical treatments initially, but surgery may be necessary if symptoms persist or worsen.