Compartment syndrome is a serious medical emergency that requires immediate treatment. It is caused by a dangerous increase in pressure in a muscle compartment which, if left untreated, can lead to tissue damage and even permanent disability. Compartment syndrome occurs particularly frequently after injuries such as bone fractures or severe bruising, but can also be caused by heavy physical exertion, e.g. in athletes. In this article, you will learn everything you need to know about the causes, symptoms, diagnosis and treatment options for compartment syndrome, as well as important preventive measures.
Overview of compartment syndrome
Compartment syndrome is a medical emergency caused by increased pressure in a muscle compartment. These compartments are surrounded by fascia, a kind of connective tissue. The increase in pressure can lead to tissue damage (necrosis) if it is not treated immediately.
Causes and risk factors
The most common causes of compartment syndrome are soft tissue injuries caused by bone fractures or severe blows to the muscles. These injuries can lead to haemorrhaging and swelling within the muscle compartment. As the fasciae cannot stretch, the pressure in the affected area increases. In rare cases, compartment syndrome can also be caused by extreme overexertion of the muscle in athletes, e.g. during marathons or intensive bodybuilding.
Abdominal compartment syndrome affects the abdomen and is caused by increased pressure in the abdominal cavity. This can be caused by bleeding, swelling or fluid accumulation after injuries or surgery, and also requires immediate medical treatment.
Disease progression
Untreated compartment syndrome leads to progressively impaired circulation, as the increased pressure impedes the blood flow. Initially, the venous blood can no longer drain away, causing the pressure to rise further and eventually, the arterial inflow of blood is also interrupted. This results in the affected muscles not getting enough oxygen or nutrients, which ultimately leads to tissue damage and tissue death (necrosis).
Symptoms
The most noticeable symptom of compartment syndrome is extremely severe pain in the affected muscle, which cannot be alleviated by conventional painkillers. Other signs are a feeling of extreme tightness in the affected area and sensory issues such as tingling or numbness. The syndrome most frequently occurs in the lower leg, forearm or foot, occasionally also after surgery.
Diagnosis
The diagnosis is made by an orthopaedic specialist and is based on the characteristic symptoms and examination of the affected extremity. Using special measuring devices, the intracompartmental pressure is measured to determine the amount of pressure in the affected muscle compartment. If increased pressure is detected, this confirms the diagnosis of compartment syndrome.
Treatment
The treatment of compartment syndrome always depends on the underlying cause:
Conservative treatment for exertional compartment syndrome
Exertional compartment syndrome caused by muscular overload can often be healed within a few days by resting and cooling the affected area.
Surgical intervention after an injury
Compartment syndrome following an injury, on the other hand, often requires immediate surgical intervention. A fasciotomy is performed in which the affected muscle fasciae are cut to relieve pressure. The surgical wound is kept open until the pressure has normalised and the tissue has recovered.
Prevention
One preventive measure against compartment syndrome is careful monitoring of injuries and early detection of symptoms. Athletes should avoid overexertion and watch out for the first signs of muscle problems. Regular stretching and warming up properly before sporting activities can help to reduce the risk of developing compartment syndrome. It is particularly important to listen to your body and take a break if you experience pain or unusual symptoms.
In addition, injuries, especially fractured bones and severe bruising, should be treated quickly and correctly to prevent the development of compartment syndrome. This includes regular check-ups by specialised medical staff and making sure to follow rehabilitation recommendations.
Preventive monitoring of compartment syndrome can be useful for people at risk, such as athletes or people with certain pre-existing conditions. This enables early intervention and prevents the development of acute compartment syndrome.
