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Compartment syndrome occurs when blood supply is dramatically reduced to muscles in a closed body space, known as a compartment. Compartments are found in the hand, forearm, upper arm, abdomen, buttock, and leg. The muscles most frequently involved are those on the front of the lower leg or the palm side of the forearm.
What is going on in the body?
A muscle group is surrounded by a tough, fibrous membrane called the fascia. Small blood vessels supply the muscle with oxygen and other essential nutrients. Insufficient blood supply to tissues and compartment syndrome can occur if:
- the muscle compartment size is reduced, as when a cast is too tight
- the muscle compartment contents are increased, such as by swelling or bleeding associated with injury
If the affected muscles are deprived of blood supply for more than 6 hours, nerve and muscle tissue can be permanently damaged or destroyed.
What are the causes and risks of the condition?
Some common causes of compartment syndrome include:
- bleeding, from a bone fracture or other injuries
- burns
- casts applied to treat bone fractures or other abnormalities
- a crush injury
- intense exercise
- leaking of intravenous fluid or injections into the compartment
- repeated use of a muscle group
- seizures that involve the muscles in the compartment
- snakebite
- swelling of the muscle itself
What are the treatments for the condition?
Diagnosis must be made accurately and promptly to assure a good outcome. Initial treatment consists of elevating the limb above the level of the heart. If a cast has been applied, it is removed. A surgical procedure known as a fasciotomy may be used to open the membrane leading to the affected muscles. Pressure is relieved, and the blood flow can return to normal. Often the skin needs to be left open for a few days. It can be closed with sutures or a skin graft after the swelling goes down.
What are the side effects of the treatments?
Surgery can cause bleeding, infection, or allergic reaction to anesthesia. The muscle and nerves may not return to normal after recovery.
What happens after treatment for the condition?
A scar may appear where the skin was left open following surgery.
How is the condition monitored?
Any new or worsening symptoms should be reported to the healthcare provider.
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