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What is a Compartment syndrome?
Compartment Syndrome is a situation which develops when pressure and swelling accumulates in a compartment which is nothing but the body space of the arms or legs. This condition is often painful. Groups of muscles, nerves, and blood vessels in the arms and legs are separated into various compartments. Each compartment is surrounded by tough layers of tissue (fascia). In compartment syndrome, pressure builds up within the layers of fascia and begins to push on the structures within that compartment.
In acute compartment syndrome, the pressure builds up suddenly, often as the result of an injury. If pressure continues to increase, it can block the flow of blood in the smallest blood vessels (capillaries). Then the muscles in the compartment cannot get enough oxygen and nutrients and will start to die within 4–6 hours. The nerves will begin to die within 12–24 hours. This condition is a medical emergency that must be treated with surgery.
Causes of Compartment Syndrome ?
- Injury. Some injuries can cause swelling or bleeding in a compartment. This can lead to compartment syndrome. Injuries that may cause this problem include:
- Broken bones, especially the long bones of the arms and legs.
- Crushing injuries.
- Penetrating injuries, such as a knife wound.
- Badly bruised muscles.
- Poisonous bites, such as a snake bite.
- Severe burns.
- Blocked blood flow. This could be a result of:
- A very tight bandage or cast
- A surgical procedure. Blood flow sometimes has to be stopped for a while during a surgery, usually with a tourniquet.
- Prolonged periods of lying in a position that restricts blood flow. This can happen in people who have nerve damage or if a person is unconscious for a long time.
- Medicines used to build up muscles (anabolic steroids).
- Medicines that keep the blood from forming clots (blood thinners).
What are the symptoms of Compartment Syndrome?
Pain is the commonest symptom of this condition. The peculiar characteristics of this pain are:
- May be far more severe than it should be for the injury you have.
- May get worse:
- When moving or stretching the affected body part.
- When the area is pushed or squeezed.
- When raising (elevating) affected body part above the level of the heart.
- May come with a feeling of tingling or burning.
- May not get better when you take pain medicine.
Other symptoms include:
- The affected region might feel full or few patients experience tightness in the area.
- A loss of feeling.
- Weakness in the area.
- Loss of movement.
- Skin becoming pale, tight, and shiny over the painful area.
- Warmth and tenderness.
- Tensing when the affected area is touched.
How is this diagnosed?
This condition may be diagnosed based on:
- Your physical exam and symptoms.
- Measuring the pressure in the affected area (compartment pressure measurement).
- Tests to rule out other problems, such as:
- Blood tests.
How is this treated?
Treatment for this condition uses a procedure called fasciotomy. In this procedure, incisions are made through the fascia to relieve the pressure in the compartment and to prevent permanent damage. Before the surgery, first-aid treatment is done, which may include:
- Treating any injury.
- Loosening or removing any cast, bandage, or external wrap that may be causing pain.
- Elevating the painful arm or leg to the same level as the heart.
- Giving oxygen.
- Giving fluids through an IV tube.
- Pain medicine.
- Compartment syndrome occurs when swelling and pressure build up in a body space (compartment) of the arms or legs.
- First aid treatment may include loosening or removing a cast, bandage, or wrap and elevating the painful arm or leg at the level of the heart.
- In acute compartment syndrome, the pressure builds up suddenly, often as the result of an injury.
- This condition is a medical emergency that must be treated with a surgical procedure called fasciotomy. This procedure relieves the pressure and prevents permanent damage.