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Compartment Syndrome

Last updated May 14, 2018

Lklundin

This image shows a compound fracture that caused Acute Compartment Syndrome with blister formation in the arm of a child.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Acute Compartment Syndrome
  • Chronic (Exertional) Compartment Syndrome
  • Compartmental Syndrome, NOS

What is Compartment Syndrome? (Definition/Background Information)

  • Compartment Syndrome is an infrequent, but painful condition that occurs when pressure within the compartment muscles (with nerves and blood vessels), increases to unsafe levels. There are compartments in the arms and legs. A compartment is covered by a layer of tissue called the fascia
  • An increased pressure can decrease the blood flow, which may lead to nerve and muscle damage, due to the inability of nourishment and oxygen to reach the nerve and muscle cells
  • Overall, Compartment Syndrome is more likely to develop in athletes, under the age of 30 years
  • Individuals, who develop Acute Compartment Syndrome, require immediate surgical treatment; permanent damage may occur, if the surgery is delayed

Compartment Syndrome is classified as the following:

Acute Compartment Syndrome:

  • It usually develops in individuals, who have recently sustained a severe injury, such as a broken bone or a crushing injury, which causes bleeding in a confined area that houses the muscles
  • Individuals, who sustain minor injuries, rarely develop this syndrome
  • Acute Compartment Syndrome requires immediate medical attention

Chronic (Exertional) Compartment Syndrome:

  • It is caused by physical activities that may cause swelling within the muscle compartment
  • Individuals, who participate in sports or other such activities that have repetitive arm or leg movements, such as running or biking, can develop Chronic Compartment Syndrome
  • Discontinuing these sports or physical activities, for a short time period, usually relieves the pain and swelling within the affected limbs
  • This is typically, a less severe condition that does not require immediate medical attention, as compared to Acute Compartment Syndrome

Who gets Compartment Syndrome? (Age and Sex Distribution)

  • Compartment Syndrome is a serious condition that may occur in individuals of all ages, races, ethnic groups, and gender
  • However, this syndrome is more likely to develop in athletes, who are below 30 years old

What are the Risk Factors for Compartment Syndrome? (Predisposing Factors)

The primary risk factors of Acute Compartment Syndrome include:

  • A crushing injury to the extremity
  • Wearing too tight, a bandage or cast
  • Participation in any rough or high-impact sport
  • Consumption of anticoagulants, which increases the risk of bleeding within a compartment
  • Individuals with a bleeding disorder, such as hemophilia

The primary risk factors of Chronic (Exertional) Compartment Syndrome include:

  • Athletes, under the age of 30 years
  • Consumption of anabolic steroids or the supplement creatine
  • Any sport or physical activity that involves repetitive motions, such as running or fast-walking

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Compartment Syndrome? (Etiology)

Common causes of Acute Compartment Syndrome include:

  • Fractures
  • A traumatic injury, such as an automobile accident or a sports-related injury
  • Use of anabolic steroids
  • Swelling of tissues underneath the skin, such as edema
  • Wearing bandages or casts that are too tight
  • A bleeding disorder, such as hemophilia
  • It can occur as a surgical complication, after a surgeon restores the blood flow, due to a blocked circulation

The primary cause of Chronic (Exertional) Compartment Syndrome is the participation in any certain sports or physical activities that requires a set of repetitive movements for prolonged periods, such as with running or fast walking.

What are the Signs and Symptoms of Compartment Syndrome?

A majority of the individuals with Acute Compartment Syndrome begin to first experience pain after a traumatic injury, such as an automobile accident. Other signs and symptoms may include:

  • A tingling or burning sensation (paresthesias) within the skin
  • Muscle tightness
  • Numbness or paralysis in the affected area
  • Change of skin color in the affected region

During exercising or a workout, individuals with Chronic (Exertional) Compartment Syndrome may experience pain or cramping that usually subsides, once the exercising is stopped. This condition usually occurs in the leg muscle. Other signs and symptoms may include:

  • Numbness in the affected extremity
  • Inability to move the foot (or limb), due to pain or cramping during physical activities
  • Visible enlargement and firmness of the muscle

How is Compartment Syndrome Diagnosed?

Diagnostic methods that a physician may use to help diagnose Compartment Syndrome include:

Acute Compartment Syndrome:

  • Individuals, who may be concerned that they have Acute Compartment Syndrome, are advised to seek immediate medical attention
  • A physician will perform a physical examination by placing a gauge in the affected muscle, to measure the compartment’s pressure. In addition to this, a complete medical history can aid in arriving at a definitive diagnosis

Chronic (Exertional) Compartment Syndrome:

  • Physical examination: To help diagnose Chronic (Exertional) Compartment Syndrome, the physicians must rule out other conditions that may be causing pain within the lower leg. During this exam, a physician may apply pressure on the tendons, to rule out tendonitis. In addition to this, a complete medical history can aid in arriving at a definitive diagnosis
  • X-ray of the leg: Physicians may order an x-ray of the shinbone (tibia), to help rule out other possible causes for leg discomfort, such as a stress fracture
  • X-ray of the forearm, if signs and symptoms are observed in the forearm

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Compartment Syndrome?

Common complications associated with Compartment Syndrome include:

  • Permanent damage to nerve or blood vessels
  • Permanent numbness or weakness in the affected muscles
  • Inability to participate in sports
  • Permanent loss of function in the affected region

How is Compartment Syndrome Treated?

Acute Compartment Syndrome is a medical emergency, with no effective non-surgical treatment methods, currently available. Surgical treatment includes:

  • Fasciotomy: Fasciotomy is a minimally invasive surgical procedure, in which the fascia covering the muscle compartment is opened, in order to relieve pain, pressure, and swelling that maybe impairing the blood flow

Treatment measures associated with Chronic (Exertional) Compartment Syndrome include both non-surgical and surgical methods. The conservative (non-surgical) methods include:

  • Non-steroidal anti-inflammatory oral medications, such as indomethacin and naproxen, may be used to treat Chronic (Exertional) Compartment Syndrome. These medications can help decrease the pain and swelling
  • A physician may prescribe orthotic devices, such as shoe inserts
  • Physical therapy: After the signs and symptoms have abated, it is important to begin some light motion exercises. Physical therapy may help restore strength, as well as improve flexibility, in the muscles

If conservative methods are not successful in treating the chronic condition, the use of surgical procedures, such as fasciotomy, may be required.

How can Compartment Syndrome be Prevented?

Currently, there are no preventative methods for Compartment Syndrome. However, by following certain guidelines, while exercising and participating in sports activities, individuals can protect themselves against a future risk for the condition. These guidelines include:

  • Warm-up with light exercises, adequate stretching, etc. before advancing to heavy exercising or commencing any sports activity
  • Keep an adequate time period, to gradually cool down, after each exercising session
  • Maintain a healthy diet
  • Stay adequately hydrated, before, during, and after exercising/sports activities

What is the Prognosis of Compartment Syndrome? (Outcomes/Resolutions)

  • The long-term prognosis of Compartment Syndrome depends on the severity of the injury that caused the condition
  • If it is diagnosed and treated early, there is an excellent chance that the affected muscles and nerves will completely recover and be fully functional
  • If Compartment Syndrome is not treated properly, there is a danger of permanent nerve injury and loss of muscle function

Additional and Relevant Useful Information for Compartment Syndrome:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/health-topics/orthopedc-disorders/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: April 15, 2014
Last updated: May 14, 2018

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