Compartment Syndrome

A Complication of Trauma With Potential Limb Threatening Outcome

Aug 15, 2008

Compartment syndrome is the result of direct trauma or intense muscle activity. If not diagnosed and treated promptly, the affected extremity may be severely damaged.

Compartment syndrome is a condition in which the pressure in the soft tissues of a limb is abnormally high, resulting in diminished blood flow to the affected extremity. Compartment syndrome usually occurs after trauma to an extremity, which causes swelling or bleeding at the injured site. The increase in fluid within a “compartment” (a muscle group surrounded by tough connective tissue known as fascia) causes increased pressure, which in turn compresses the blood vessels and compromises blood flow. If not treated immediately, compartment syndrome can cause nerve damage, muscle damage, loss of the affected limb, or in extreme cases, death.

Cause of Compartment Syndrome

Compartment syndrome is usually associated with blunt trauma. Long bone fractures and crush injuries may result in elevated soft tissue pressure in a limb, due to bleeding and swelling in a closed space (the “compartment”). Other causes include burns, bleeding disorders, anticoagulation therapy (blood thinners), arterial injury, and acute leg vein clots.

Symptoms of Compartment Syndrome

Although these are considered the classic signs of the condition, they are not always present in all cases. Pain and parasthesias are the most common of these symptoms.

Diagnosis of Compartment Syndrome

Diagnosis of compartment syndrome is primarily on a clinical basis. Lab tests generally do not play a prominent role in making the initial diagnosis. The diagnosis is suspected when the patient complains of increasing pain after trauma or after severe exertion. Findings on physical examination may include increased size of the affected extremity (compared to the unaffected side), or increased firmness of the affected limb. A tonometer may be used to directly measure pressure in a compartment, giving direct evidence of the condition.

Imaging studies which may be used include plain x-rays to evaluate for fractures, and Doppler ultrasound to assess the integrity of the arteries and veins of the limb.

Most Common locations of Compartment Syndrome

Treatment of Compartment Syndrome

Surgery is the definitive treatment for compartment syndrome. Fasciotomy, or cutting the tough outer layer of the compartment, is performed to relieve the pressure and prevent damage to the limb.

Complications of Compartment Syndrome

The copyright of the article Compartment Syndrome in Muscle Injuries is owned by Steven M. Cohen. Permission to republish Compartment Syndrome in print or online must be granted by the author in writing.