What is compartment syndrome? Compartment syndrome (SIN-drohm) is a condition that occurs when pressure increases within a compartment (closed space) in your body. Inside this compartment are muscles, nerves, and blood vessels that are enclosed by a fascia. The fascia is a thick layer of special protective tissue that does not expand (grow). Compartment syndrome happens when there is swelling in the compartment. This swelling inside the compartment puts pressure on the muscles, blood vessels, and nerves. Blood flow to the compartment may be blocked and lead to muscle and nerve injury. Over time, the injured limb (arm, leg, hand, or foot) may not work anymore.
What causes compartment syndrome? Compartment syndrome may be caused by any of the following:
Direct pressure: Bandages or casts that are too tight.
Fracture or crush injuries: The most common cause of acute (short-term) compartment syndrome is a broken bone, especially in the shin (lower leg) bone. Getting trapped under a heavy object or lying in an awkward position after fainting may also cause compression (pressure in the compartment).
Medicines or illegal drugs: Blood thinning medicine may cause bleeding in the compartment. Street drugs that are injected through the veins, such as morphine or heroin, may also increase pressure.
Muscle overuse: Long-lasting exercise, such as marathon running or long distance biking.
Soft tissue injury and other medical conditions: Gunshot or stab wounds, direct blows, car accidents, or falls may cause injuries and bleeding which lead to compartment syndrome. Burns, bleeding problems, infections, allergies, or insect or snake bites can also lead to compartment syndrome.
Surgery: Having lengthy surgery where your legs are raised to a level that is higher than your heart.
What are the signs and symptoms of compartment syndrome? Pain is the earliest sign of compartment syndrome. The pain usually increases when the injured area is stretched or bent. Your limb may be numb, hard, swollen, or have a full feeling as if fluids are filling it. The skin may be pale or shiny and you may have trouble moving the injured limb.
How is a compartment syndrome diagnosed? One or more of the following tests may be done:
Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
Doppler flowmetry: This test checks the flow of blood in your muscles. This may help caregivers feel or hear the blood flow in the injured compartment.
Magnetic resonance imaging scan: This test, also called an MRI, uses magnetic waves to take pictures. During an MRI, pictures are taken of your bones, muscle, joints, and blood vessels. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal object. This may cause serious injury.
Muscle compartment pressure measurement: The increased pressure within the compartment may be measured with special tools. A long needle attached to a special machine that measures pressure is put into the injured muscle.
Near infrared spectroscopy: This test uses infrared (light beam) to show changes in the muscle.
Scintigraphy: This is a test to look at the flow or movement of blood through the compartment area. You are given a small amount of dye in an IV. Pictures are then taken of your blood vessels, muscles, or bones.
Urine test: A sample of your urine is collected and sent to a lab for tests. This may help caregivers know when muscles are breaking down and if your kidneys are affected.
How is compartment syndrome treated? If you have a cast or bandages caregivers may remove them. Doing this may decrease pressure in your muscles. You may also need one or more of the following:
Brace or crutches: You may need to wear a brace to stop your limb from moving. This brace may correct, support and protect the body part. Caregivers may give you crutches to decrease stress and strain on your leg if that is where the compartment syndrome is.
Surgery: Caregivers may do a fasciotomy to decrease pressure and swelling. A long incision (cut) is done in the fascia of the injured compartments.
Rehabilitation: This is a program that helps bring back your limb's normal range of motion and strength. A physical or occupational therapist may exercise your arms, legs, and hands. They may also teach you new ways to do daily activities and care for yourself. This therapy teaches you special skills for bathing, dressing, eating, or driving.
What problems can compartment syndrome cause? If compartment syndrome is not treated quickly, you may develop an infection. The nerves of the arm or leg with this problem may be hurt or stop working, and you may not be able to move the limb. Scars may form and the limb may not look or work the same as before. You may need surgery to remove the arm or leg. You may develop kidney or heart problems as a result of compartment syndrome.
How can compartment syndrome be prevented?
You may need to keep your limb raised if you get injured. If you need to wear a cast, brace or bandage, prop the injured limb on a pillow to be at the same level as your heart. Raising your limb higher than this may cause compartment syndrome.
Make sure your bandages are not too tight.
Rest right away if you feel pain while exercising.
Wear shoes with soft cushion, flexible soles, and low heels. Avoid running on hard surfaces.
Do warm-up or stretching exercises before exercising. Ask your caregiver for an exercise program, such as cross-training, to use a variety of muscles.
Where can I find support or more information? Compartment syndrome may be life-changing for you and your family. You and those close to you may feel afraid and worried. These are normal feelings. Talk to your caregivers, your family, or friends about your feelings. Contact the following for more information about compartment syndrome:
American Academy of Family Physicians 11400 Tomahawk Creek Parkway Leawood, KS 66211-2680 Phone: 1-913-906-6000 Phone: 1-800-274-2237 Web Address: http://www.aafp.org
American Academy of Orthopaedic Surgeons 6300 North River Road Rosemont, IL 60018-4262 Phone: 1-847-823-7186 Web Address: http://www.aaos.org/
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
