Quick and Dirty Guide to Compartment Syndrome:
Each GROUP of muscles, nerves and vessels are kept separated from each other into little compartments by a fibrous mesh. (Example: Compartments in the leg) This mesh is called fascia. When the muscles inside the fascia are damaged, they swell. Fascia (the netting that holds the group together) does NOT expand to permit the swelling. So, what happens is that the swelling increased the pressure within the “compartment” to the point where it doesn’t allow blood flow or transmission of sensory impulses. If it isn’t handled quickly, the muscle tissue goes too long without oxygen, it dies and the extremity must be amputated.
The most common situations where you will find compartment syndrome is in the calf or forearm after a car accident or other traumatic blunt force injury. Look specifically for decreased sensation, severe pain that doesn’t respond to painkillers and gets worse over time as pressure increases and gradual weakness or loss of sensation distal to injury site. The skin over the area may be swollen and waxy looking. Squeezing the compartment or moving the affected part will evoke extreme pain.
When you get to the ER, they will confirm the diagnosis by attaching a pressure gauge on the end of a needle and jamming it into the muscle to measure pressure within the compartment. If confirmed, the patient will need surgery where they will cut the fascia to relieve the pressure, similar to the reasoning behind an escharotomy in severe burn patients. All of that pressure has to be released. A follow up surgery is required to close the fascia again in a few days. As long as the compartment syndrome has been addressed before muscle and nerves begin to die, the prognosis is great!