What Is Compartment Syndrome?

Compartment syndrome is a serious medical condition that involves increased pressure within a muscle compartment, leading to reduced blood flow to the tissues and potential damage to nerves and muscles. When blood flow to the muscles and nerves is compromised due to the increased pressure, it can lead to tissue ischemia (lack of oxygen) and damage. Without prompt treatment, compartment syndrome can result in tissue necrosis (death), permanent nerve damage, and muscle dysfunction.

Compartment syndrome can be either acute or chronic. Acute compartment syndrome is a medical emergency, and typically caused by a severe injury. Left untreated, acute compartment syndrome can lead to permanent muscle damage. Chronic compartment syndrome is also known as exertional compartment syndrome, and is reversible with rest.

How is compartment syndrome diagnosed?

Doctors use something called the “Five Ps” to diagnose compartment syndrome. This involves:

1. Pain: Persistent, severe pain that is out of proportion to the injury or condition is a classic symptom of compartment syndrome. The pain often worsens with movement or stretching of the affected muscles and may not be relieved by rest or pain medication.
2. Paresthesia: Paresthesia refers to abnormal sensations such as tingling, numbness, or pins and needles sensations in the affected limb. Patients with compartment syndrome may experience paresthesia due to compression of nerves within the muscle compartment.
3. Pallor: Pallor, or paleness of the skin, may be observed over the affected area due to compromised blood flow and tissue perfusion. The skin may appear pale or mottled compared to surrounding areas.
4. Pulselessness: In advanced cases of compartment syndrome, arterial blood flow to the affected limb may become compromised, leading to diminished or absent pulses at the site of injury.
5. Paralysis: Paralysis or weakness of the affected muscles may occur due to nerve compression and ischemia (lack of oxygen). Patients may experience difficulty moving the affected limb or exhibit muscle weakness in comparison to the unaffected limb.

These five Ps are a mnemonic to help healthcare providers recognize the signs and symptoms of compartment syndrome and prompt timely evaluation and intervention. It’s important to note, however, that not all patients with compartment syndrome will exhibit all five Ps, but the presence of one or more of these signs necessitates further assessment and consideration of compartment syndrome as a potential diagnosis. Early recognition and treatment of compartment syndrome are critical to prevent tissue damage and long-term complications.

If you are experiencing any of these symptoms, you should seek medical attention right away.

What causes compartment syndrome?

Compartment syndrome typically occurs due to an increase in pressure within a muscle compartment, which can be caused by various factors. Here are some common causes of compartment syndrome:

• Trauma: Traumatic injuries such as fractures, crush injuries, or severe contusions can cause swelling and bleeding within the affected muscle compartments. The increased pressure resulting from the accumulation of blood, fluid, or edema within the compartment can lead to compartment syndrome.
• Fractures: Fractures, particularly those involving long bones such as the tibia (shin bone) or forearm, are a common cause of compartment syndrome. The swelling and inflammation associated with fractures can compress the surrounding muscle compartments, leading to increased pressure. Cleveland Clinic reports around 10% of those who fracture their tibia develop compartment syndrome.
• Crush injuries: Crush injuries, such as those sustained in accidents or falls, can result in significant tissue damage and swelling. The compression of muscles and blood vessels by the crushing force can lead to compartment syndrome if not promptly addressed.
• Prolonged immobilization: Prolonged immobilization of a limb, such as being in a cast or splint for an extended period, can lead to muscle atrophy, stiffness, and reduced blood flow. Upon removal of the immobilization device, rapid swelling and inflammation may occur, increasing the risk of compartment syndrome.
• Medical procedures: Certain medical procedures, such as limb positioning during surgery or the use of tight bandages or casts, can inadvertently increase pressure within muscle compartments. If not carefully monitored, these factors can predispose a person to develop compartment syndrome.

The specific causes of compartment syndrome can vary depending on your individual circumstances. However, if you experience symptoms that might suggest compartment syndrome – like severe pain, swelling, or weakness in a limb, especially after an injury – seek immediate medical attention. A prompt diagnosis and proper treatment can lessen the risk of permanent tissue damage.

What are the treatments for compartment syndrome?

Treatment for compartment syndrome depends on whether it’s acute or chronic.

Acute compartment syndrome is a medical emergency and requires immediate surgery called a fasciotomy. During a fasciotomy, the surgeon makes incisions in the skin and the tissue covering the muscle compartment (fascia) to relieve pressure. In some cases, the skin may not be able to be closed immediately and a skin graft may be needed later.

Chronic compartment syndrome may be treated with non-surgical methods, such as:

• Resting the affected area:This helps reduce swelling and inflammation.
• Ice:Applying ice to the affected area can help reduce pain and swelling.
• Anti-inflammatory medications:Over-the-counter medications like ibuprofen or naproxen can help reduce pain and inflammation.
• Physical therapy:Physical therapy can help improve flexibility and strength in the affected muscles.
• Orthotics:Orthotics are shoe inserts that can help improve the alignment of your foot and ankle and reduce pressure on the affected muscles.

In some cases, however, surgery may be necessary to treat chronic compartment syndrome. The type of surgery will depend on the severity of your condition.

What are the complications of compartment syndrome?

Compartment syndrome, if left untreated, can lead to serious complications. These complications arise because the increased pressure within a muscle compartment restricts blood flow, depriving tissues of oxygen and nutrients. This can lead to:

• Muscle damage and death (necrosis): Without adequate blood flow, muscle cells begin to die. This can lead to permanent muscle weakness and loss of function.
• Nerve damage: The increased pressure can also damage nerves, which can cause pain, numbness, tingling, and weakness.
• Rhabdomyolysis: This is a condition in which damaged muscle tissue breaks down and releases harmful substances into the bloodstream. These substances can damage the kidneys and other organs.
• Contractures: Over time, damaged muscle tissue can contract and stiffen, leading to deformity and limited movement in the affected limb.
• Amputation: In severe cases, if tissue death is extensive, amputation of the affected limb may be necessary.

Early diagnosis and treatment of compartment syndrome are essential to prevent these complications. If you experience any of the symptoms of compartment syndrome, such as sudden, intense pain in an extremity, swelling, and numbness or tingling, seek medical attention immediately.

If you or a loved one developed compartment syndrome after an accident that wasn’t your fault, it’s important to talk to an experienced attorney as soon as possible. At Claggett & Sykes, our attorneys can help you secure compensation for your injuries, losses, and pain and suffering. We are here to help. To schedule a free consultation, call us or use our contact form. We have offices in both Las Vegas and Reno to better serve our clients.