Compartment Syndrome (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- Compartment syndrome facts
- What is compartment syndrome?
- What causes compartment syndrome?
- What are the risk factors for compartment syndrome?
- What are the symptoms and signs of compartment syndrome?
- When should I seek medical care for compartment syndrome?
- How is compartment syndrome diagnosed?
- What is the treatment for compartment syndrome?
- Surgery (fasciotomy)
- What are the complications of compartment syndrome?
- What is the prognosis for compartment syndrome?
- Find a local Internist in your town
When should I seek medical care for compartment syndrome?
Acute compartment syndrome is a true emergency. If the pressure within the compartment is not released within a few hours, permanent muscle and nerve damage may occur.
Medical care should be accessed when numbness, tingling, weakness, or excessive pain occurs after an injury. While compartment syndrome is most often due to injuries of the forearm and lower leg, it may also occur in the hand, foot, or buttocks after a broken bone or crush injury.
How is compartment syndrome diagnosed?
While it is uncommon, the health care practitioner has to have a high index of suspicion for acute compartment syndrome if a patient presents with excessive pain, numbness, and a tense extremity after an injury. The patient's history of an injury to the extremity often is all that is necessary for a diagnosis.
While blood tests may be ordered to look for chemical markers of muscle injury (for example, myoglobin and lactate levels) and kidney damage, the definitive diagnosis of compartment syndrome is confirmed by measuring the pressure within the compartments of the affected limb. A sterile needle is inserted directly into the muscle compartment and attached to a pressure monitoring device (see second-last reference for picture). Usually, pressure measurements (see values listed above) are taken in each compartment in the affected limb and this may require multiple needle sticks.
Chronic compartment syndrome may be diagnosed clinically but compartment pressures may be measured before and after exercise to confirm the diagnosis. The health care professional should also explore other potential causes of pain due to exercise, including stress fractures, shin splints, or tendon inflammation.
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