Compartment Syndrome

Compartment syndrome(CS) occurs when the intracompartmental pressure compresses the neurovascular structures in an osseofascial space. It can occur in the leg (most common), foot, hand, forearm, arm, shoulder, thigh, and buttocks, with or without fractures. Some diseases predispose to compartment syndrome, including hemophilia, sickle cell disease, and anticoagulant use. The majority of cases occur after trauma (acute or repetitive).

Causes

• The main cause of compartment syndrome is Swelling and it is associated with high-energy trauma, such as includes from a car accident or crush injury.
• Compartment syndrome may also occur due to tight bandages or casts and it also caused significant swelling. Pressure will build up and then it may cause compartment syndrome.
• Chronic compartment syndrome may be caused by repetitive activities such as running. Because it increase the pressure in a compartment only during that activity.
• Swelling that causes CS may be caused by decreased blood flow, bleeding, fluid buildup, or other factors.

Symptoms

• Pain +++++ (may be out of proportion to injury)
• Tightness and swelling
• Throbbing
• Paresthesias
• Weakness (late)
• Numbness (late)

Signs

• Swollen, tense compartment +++++
• Pain ++++ is exacerbated by passive stress of the compartment in question, although the severity of pain on passive stretch or palpation does not predict the amount of pressure.
• Diminished two-point discrimination +++
• Hyperesthesia
• Anesthesia
• Skin may be shiny and warm
• Weakness (late)
• Loss of pulse (late)

Treatment

• For the treatment of CS, the non-surgical treatment is usually effective. This treatment includes such as avoiding doing activities that may cause pain and swelling, and you can also apply ice and elevating the limb slightly. You can also take aspirin or ibuprofen to reduce inflammation.
• Another treatment for CS is surgery that is known as fasciotomy. It helps in splitting of the deep tissues to allow more room for the muscles to expand. In which, Pressure measurements are taken before and after surgery to determine success of the decompression. But the biggest problems faced after this type of surgery are includes wound breakdown, infection and haematoma formation.
• For the treatment of both acute and chronic CS is surgery. In which surgery, the wounds are generally left open and closed during a second surgery, usually 48-72 hours later. If bandage is causing any problem, then dressing should be loosened or cut down to relieve the pressure.