What is Compartment Syndrome?
Compartment syndrome develops when swelling or bleeding occurs within a muscle compartment causing the pressure inside of the compartment to increase to a critical level. The compartment is a group of muscles that is surrounded by tissue known as fascia. Since fascia does not stretch, this swelling can cause increased pressure on the blood vessels, nerves, and muscles in the compartment. This increased pressure can then lead to decreased oxygenation and nutrition to these vital cells. Ultimately, this can result in permanent damage to these structures.
Acute vs Chronic Compartment Syndrome
Compartment syndrome can be either acute or chronic. Acute compartment syndrome is a rare occurrence and is usually caused by swelling after a severe injury or fracture. Other potential causes can be a badly bruised muscle, reestablishment of blood flow after blocked circulation, crush injuries, or constricting bandages such as a tight cast or splint. This is most often seen in the forearm or lower leg.
Acute Compartment Syndrome
Acute compartment syndrome is a surgical emergency since without prompt treatment, it can cause permanent muscle or nerve damage. If you have concerns about compartment syndrome then you must contact your doctor immediately. The number one sign of acute compartment syndrome is progressively worsening pain that appears to be more severe than would be expected for the injury. Other classic signs of acute compartment syndrome are:
- Pain with passive stretch of the involved muscles.
- Tingling or burning sensation of the skin
- A firm or tight feeling around the muscle
- Paralysis of the muscle.
- Pale color of fingers/toes
Treating Acute Compartment Syndrome
There is no effective nonsurgical treatment for compartment syndrome. If it is unclear whether a compartment syndrome is developing, the doctor may measure the pressure within the concerned muscle compartment with a specialized needle. In acute compartment syndrome, surgical decompression of the compartment is required to relieve this pressure. Your doctor will make an incision and cut open the skin and fascia covering the affected compartment in order to decompress the muscle compartment. This procedure is called a fasciotomy.
Chronic Compartment Syndrome
Chronic compartment syndrome (also called exercise-induced compartment syndrome) is caused by overuse, which leads to swelling of the muscles in a compartment. Exercise-induced compartment syndrome is typically seen in the lower legs where there are four primary compartments. Any one or more of the compartments may be affected.
Symptoms of Chronic Compartment Syndrome
Patients with exercise-induced compartment syndrome will notice pain in the lower leg soon after starting to run which will resolve with rest. They may occasionally find numbness in the foot or ankle as well.
Diagnosing Chronic Compartment Syndrome
Exercise-induced compartment syndrome may be diagnosed by testing the compartment pressures following exercise. If the compartment syndrome does not resolve, the patient may be treated with a decompressive fasciotomy of the affected compartments.
When To See The Pediatric Orthopedic Center
If you feel your child is experiencing symptoms or signs related to this condition, it may be time to visit us. The Pediatric Orthopedic Center is the premier NJ hub for pediatric orthopedics, with three offices throughout northern NJ. Having been the leader in pediatric orthopedics in this area for 30 years, we are the largest and most award-winning pediatric orthopedic practice in the tri-state area.
