Compartment Syndrome

Compartment syndrome refers to muscle swelling and resulting complications. It most typically occurs in the leg or arm. The leg, for example, contains four muscle compartments, each surrounded by tissue called the fascia. When the muscle group within one or more of the compartments swells, it is contained by the fascia. Unlike skin, ligaments or other soft tissues, fascia does not stretch. This leaves no room for the muscles to expand, leading to damage to the muscle tissue as well as to neighboring blood vessels and nerves. There are two major types of compartment syndrome.

Acute compartment syndrome

This is a medical emergency that requires immediate surgery to prevent the possible necrosis (death) of muscles, nerves and/or blood vessels. The surgery, called a fasciotomy, involves cutting open the fascia to allow the muscle to swell without causing additional damage. Anyone with this condition should go to the nearest emergency room.

Acute compartment syndrome is usually caused by an impact trauma, such as a bone fracture or severely bruised muscle. The condition is commonly associated with automobile and industrial accidents, as well as competitive sports. It can also sometimes be caused by a splint, bandage or cast that is fitted too tightly. In these cases, loosening the constriction, if done in a timely manner, may avoid the need for surgery.

Common symptoms of acute compartment syndrome are:

• Unexpectedly intense pain in the muscle, which worsens with use
• Burning or tingling in the skin or feelings
• Numbness
• Muscle tightness

Chronic (exertional) compartment syndrome

Chronic compartment syndrome is an overuse injury usually found in athletes and primarily affecting the legs (especially the quads or calves). The associated swelling and potential for tissue damage less severe than in acute compartment syndrome. Altering or ceasing activity may allow the muscle inflammation to subside, but if this does not work, a fasciotomy may be required.

Common symptoms of chronic compartment syndrome are:

• Numbness
• Conspicuous swelling of the muscle
• Restriction of movement in the leg or foot