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The pain is made worse by passively stretching the muscle bellies traversing the affected fascial compartment. ![]() The most reliable symptom of compartment syndrome is severe pain, disproportionate to the injury, which is not readily improved with initial measures (such as analgesia, elevation to the level of the heart, and splitting a tight cast). ![]() Symptoms tend to present within hours, although it can develop up to 48 hours post-insult. ![]() Paraesthesia is therefore a common symptom.Īs the intra-compartmental pressure reaches the diastolic blood pressure, the arterial inflow will be compromised, and the leg will become ischaemic. This causes a sensory +/- motor deficit in the distal distribution. Next, the traversing nerves are compressed. This increases the intra-compartmental pressure further. This increases the hydrostatic pressure within them, causing fluid to move down its gradient and out of the veins in to the compartment. 2).Īs pressure increase, the veins will be compressed. Other causes include iatrogenic vascular injury, tight casts or splints, deep vein thrombosis, and post-reperfusion swelling.įascial compartments are closed and cannot be distended consequently, any fluid that is deposited therein will cause an increase in the intra-compartmental pressure (Fig. Compartment syndrome: the importance of early diagnosis.Figure 1 – Cross section of the muscles of the distal forearm, highlighting those of the posterior compartment PathophysiologyĬompartment syndrome typically occurs following high-energy trauma, crush injuries, or fractures that cause vascular injury. Journal of Pediatric Orthopaedics, 21(5), 680-688 Acute compartment syndrome in children: Contemporary diagnosis, treatment, and outcome. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. We link primary sources - including studies, scientific references, and statistics - within each article and also list them in the resources section at the bottom of our articles. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. as the cells die, the muscle can release various chemicals that can damage the kidneys.fasciotomy may cause permanent scarring.permanent muscle damage and reduced function in the affected limb.In some cases, acute compartment syndrome and its treatment can lead to: This may help to restore a full range of motion and muscle strength. If surgery is undertaken, some people may need a course of physiotherapy to help with the recovery process. Here, a doctor makes a cut in the fascia to give the muscles room to swell. ![]() Surgery is also an option if all other treatments have failed. People may also be advised to avoid the activity causing the problem. Options to treat chronic compartment syndrome include physiotherapy, shoe inserts, and anti-inflammatory medications. The procedure, called a fasciotomy, involves a surgeon cutting open the skin and the fascia to relieve the pressure. The only option to treat acute compartment syndrome is surgery. Share on Pinterest If compartment syndrome is suspected, patients should be directed to the emergency room.
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