Department of hand surgery & Microsurgery.

Acute Compartment Syndrome

What is Compartment syndrome

Compartment syndrome is a painful and potentially serious condition caused by bleeding or swelling within an enclosed bundle of muscles – known as a muscle compartment. Each group of muscles in the arms and legs, together with nearby blood vessels and nerves, is contained in a space surrounded by tissue called fascia. Compartment syndrome occurs when the pressure within a compartment increases, restricting the blood flow to the area and potentially damaging the muscles and nearby nerves. It usually occurs in the legs, feet, arms or hands, but can occur wherever there's an enclosed compartment inside the body.

Types of compartment syndrome

There are 2 main types of compartment syndrome: acute compartment syndrome and chronic (also called exertional) compartment syndrome.

Acute compartment syndrome:

  • Happens suddenly, usually after a fracture or severe injury
  • Is a medical emergency and requires urgent treatment
  • Can lead to permanent muscle damage if not treated quickly

Chronic compartment syndrome:

  • Happens gradually, usually during and immediately after repetitive exercise (such as running or cycling)
  • Usually passes within minutes of stopping the activity
  • Is not a medical emergency and does not cause permanent damage
Symptoms of Acute compartment syndrome

Symptoms of acute compartment syndrome usually develop after an injury and get quickly worse. Symptoms can include:

  • intense pain, especially when the muscle is stretched, which seems much worse than would normally be expected for the injury
  • tenderness in the affected area
  • tightness in the muscle
  • a tingling or burning sensation
  • in severe cases, numbness or weakness (these are signs of permanent damage)
When to get medical advice

Acute compartment syndrome is a medical emergency and ideally needs to be treated in hospital within a few hours to avoid permanent damage to the muscles or nerves.

Causes of Acute Compartment syndrome

Acute compartment syndrome can be caused by:

  • a broken bone or a crush injury – this is the most common cause
  • a plaster cast or tight bandage being applied to a limb before it has stopped swelling
  • burns, which can cause the skin to become scarred and tight
  • surgery to repair a damaged or blocked blood vessel (once blood is able to flow back into a muscle, it can lead to swelling)
Treatments for Acute Compartment syndrome

Acute compartment syndrome must be treated in hospital using a surgical procedure called an emergency fasciotomy. The doctor or surgeon makes an incision to cut open your skin and fascia surrounding the muscles to immediately relieve the pressure inside the muscle compartment. The wound will usually be closed a few days later. Occasionally, a skin graft may be required to cover the wound.

What happens if treatment is not taken ?

Acute compartment syndrome is a serious condition. Failure to treat may result in contractures and reduced limb functions ( Volkmann’s ischemic contracture ) or lose of limb or threat to life.