By Joan McLoud, Physical Therapist
Compartment Syndrome Overview
Compartment syndrome is a condition in which increased pressure within one of the body’s anatomical compartments result in insufficient blood supply to tissue within that space. There are two main types: acute and chronic. Compartments of the arm and leg are the most common.
The components of this condition are symptoms, diagnosis, treatment, and rehab or aftercare.
Acute Compartment Syndrome
Symptoms of acute compartment syndrome(ACS) can include severe pain, poor pulses, decreased ability to move, numbness or a pale color of the affected limb. It is most commonly due to physical trauma such as bone fracture, or crush injury. Diagnosis is generally based upon a person’s symptoms. Treatment is by surgery to open the compartment in a timely manner. If not treated with about 6 hours, permanent muscle or nerve damage can result.
Chronic Compartment Syndrome
In chronic compartment symptoms, there is generally pain with exercise. Other symptoms may include numbness. Symptoms typically resolve with rest. Common activities that trigger chronic compartment syndrome include running and biking. Generally this condition does not result in permanent damage. Treatment may include physical therapy or if that is not effective, surgery. The surgery for this condition is called a Fasciotomy.
How the body handles this condition
Groups of organs or muscles are organized into areas called compartments. Strong webs of connective tissue called fascia form walls of these compartments. After an injury, blood or edema (fluid resulting from inflammation or injury) may accumulate in the compartment. Severe tissue damage can result when pressure builds in these areas.
Causes of Compartment Syndrome
About three quarters of the time, acute compartment syndrome is caused by a broken leg or arm and develops rapidly. This condition can develop from the fracture itself or treatment after casting or surgery.
Compartment Syndrome Symptoms
There are five characteristic signs and symptoms related to this condition:
Pain, paraesthesia (reduced sensation), paralysis, pallor, and the lack of a pulse. Pain and paraesthesia are early symptoms of this condition.
Intracompartmental pressure can also be important for diagnosis. An instrument is inserted 5cm into the zone of injury. Higher than 30 mmHg of the diastolic pressure is associated with compartment syndrome.
Fasciotomy is indicated in the above conditions. Surgery to release the pressure in the area. The area needs to be left open as the condition heals. Chronic compartment syndrome can be treated conservatively or surgically. Conservative treatment consists of rest, anti-inflammatory medications, and manual decompression. The key to successful treatment of compartment syndrome is early diagnosis and effective treatment. Although this condition does not happen all the time the more we are aware of signs and symptoms the faster we can seek treatment or be treated shortly after surgery.
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JOI Physicians are currently offering ASAP Fracture care. Make an appointment by calling (904)JOI-2000. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care.
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By: Joan McLoud, PT