Understanding Compartment Syndrome

A Comprehensive Guide to Diagnosis, Treatment, and Prevention

Orthopedics

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Last updated: Mar 24, 2025

What is Compartment Syndrome?

Compartment syndrome is a serious condition that occurs when pressure builds up within a muscle compartment, leading to decreased blood flow and potential tissue damage.

Types

  • Acute compartment syndrome: Develops rapidly, usually after injury
  • Chronic compartment syndrome: Develops gradually, often from exercise

Common Causes

  • Fractures or severe bruising
  • Tight bandages or casts
  • Crush injuries
  • Intense exercise (especially in chronic cases)
  • Burns
  • Blood clots

Key Symptoms

Acute Compartment Syndrome

  • Severe pain (out of proportion to injury)
  • Pain that worsens with passive stretch
  • Firmness or tightness in affected area
  • Numbness or tingling
  • Pale, shiny skin
  • Decreased pulse

Chronic Compartment Syndrome

  • Exercise-induced pain
  • Tight, aching muscles
  • Numbness during activity
  • Symptoms typically resolve with rest

Diagnosis

  • Physical examination
  • Compartment pressure measurements
  • MRI or other imaging (in some cases)

Treatment Options

Acute Cases

  1. Emergency fasciotomy
    • Surgical decompression
    • Must be performed quickly to prevent tissue death

Chronic Cases

  1. Conservative treatment
    • Activity modification
    • Physical therapy
    • Anti-inflammatory medications
  2. Surgical options
    • Fasciotomy if conservative treatment fails

Prevention

  • Remove restrictive clothing/bandages
  • Proper injury management
  • Gradual increase in exercise intensity
  • Regular monitoring of casts and dressings

When to Seek Emergency Care

  • Severe pain that seems excessive
  • Numbness or tingling
  • Pale or cool extremities
  • Significant swelling
  • Loss of pulse

Long-term Outlook

Prognosis depends on quick recognition and treatment. Early intervention typically leads to better outcomes.

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