Compartment Syndrome (Chronic)
At UW Health in Madison, Wisconsin, our Heart and Vascular Care team provides expert treatment for compartment syndrome.
Compartment syndrome involves the compression of nerves and blood vessels within an enclosed space. The increased pressure within the muscles that is caused by the condition can lead to blood flow impairment and damage to the muscle and nerve.
What is Compartment Syndrome?
Muscle groups in arms and legs are separated by thick layers of tissue called fascia. Inside the layers of fascia is a confined spaced, called a compartment, which is home to the blood vessels, nerves and muscle tissue.
Because fascia do not expand, swelling in the compartment can lead to increased pressure, which compresses the nerves, blood vessels, and muscles. Blood flow to the compartment can be blocked if the pressure gets too high. This can lead to impaired function and occasionally permanent injury to the muscle and nerves. If the pressure is prolonged, there is a risk that the limb will need to be amputated.
Causes and Symptoms
Trauma caused by vehicle or motorcycle accidents, surgical complications or crush injuries can often lead to acute compartment syndrome; whereas chronic compartment syndrome is characterized by pain and swelling repetitious activity such as exercising and subsides after the activity is discontinued.
Compartment syndrome is characterized by severe pain that does not decline with elevation or pain medication. Decreased sensation, numbness or paralysis can occur in advanced cases.
How is Compartment Syndrome diagnosed?
Diagnosis of compartment syndrome is confirmed with the measurement of pressures in the compartment by inserting a pressure-metered needle into the compartment. Normal compartment pressures are less than 15mmHg. Acute compartment syndrome is associated with pressures greater than 45 mmHg or when the pressure is within 30mmHg of the diastolic blood pressure (the lower number of the blood pressure).
Chronic compartment syndrome typically yields pressures of greater than 25mmHg. The outlook for recovery from compartment syndrome is excellent with prompt diagnosis and treatment.
How is Compartment Syndrome treated?
Surgical treatment is available for both acute and chronic compartment syndrome. Skin incisions are made and sections of the fascia are removed to release the increased pressure. For acute compartment syndrome, the wounds are generally covered with a sterile dressing and left open, but closed during a second surgery 48-72 hours later. Skin grafts may be required to close the wound. Incisions for chronic compartment syndrome are small (two inches) and closed after fascia removal.