Compartment syndrome refers to the compression of the nerves and blood vessels in a particular area of the body. The syndrome is characterized by severe pain that is not alleviated by pain medication or elevation of the affected body part. In the most serious cases, symptoms may include a lack of sensation in the affected area, skin discoloration, and weakness.
Compartment syndrome is most common in the lower extremities such as the forearm or legs. However, it can occur in the arms and hands as well.
Muscles are separated by thick layers of tissue called fascia. Each group of muscles are contained or compartmentalized by the fascia. Inside the fascia, there are muscles, blood vessels, and nerves. If the fascia becomes swollen due to trauma, increased pressure within the compartment may lead to a decrease of blood flow. If the situation remains untreated, the muscles, blood vessels, and nerves may be permanently damage. The damage can be so severe that it leads to amputation of the limb or body part.
A timely and proper diagnosis of compartment syndrome is vital to repair the damage and avoid permanent loss of the limb. A physical examination can reveal symptoms such as swelling, shiny skin, and severe pain in the area when squeezed. Compartment syndrome should be confirmed through a diagnostic test. A test can be performed by inserting a needle (attached to a pressure gauge) into the affected area. If the pressure is greater than 45 mmHg or when the pressure is within 30 mmHg of the diastolic blood pressure (the lower number of the blood pressure), compartment syndrome is diagnosed.
Surgery is normally required to relieve the pressure and avoid further damage to the nerves, blood vessels and muscles. Once the surgery is performed successfully, prognosis is generally good for a full recovery. However, if the surgery is delayed or compartment syndrome is misdiagnosed, the patient may suffer severe and permanent injury such as amputation.