Compartment Syndrome

WHAT YOU SHOULD KNOW:

• Compartment syndrome (SIN-drohm) is a condition that occurs when pressure increases within a compartment (closed space) in the body. Inside this compartment are muscle tissues, nerves, and blood vessels that are enclosed by a fascia. The fascia is a thick layer of special protective tissue that does not expand (grow). Compartment syndrome happens when there is swelling in the compartment. This swelling inside the compartment puts pressure on the muscles, blood vessels, and nerves. Blood flow to the compartment may be blocked and lead to muscle and nerve injury. Over time, the injured limb (arm, leg, hand, or foot) may not work anymore.
  
  
• Common signs or symptoms of compartment syndrome include severe pain, swelling, and weakness. You may also have tingling, tenderness, and a tense (tight) or full feeling in the affected muscles. Your skin may be pale and you may have trouble moving the injured limb. Blood and urine tests, muscle compartment measurement, and laser doppler flowmetry may be used to diagnose compartment syndrome. Treatment may include removing a tight cast, medicines for pain, or surgery to decrease the pressure and swelling.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Medicine used to treat compartment syndrome may cause nausea (upset stomach), vomiting (throwing up), or stomach ulcers (sores). You may bleed or get an infection if you have surgery. If this condition is not treated as soon as possible, your muscles and nerves may have permanent damage. Blood supply may decrease to the injured area. Your arm or leg may get weak, and you may have problems moving it. If this condition is not treated, you may need an amputation (removing all or part of the injured arm or leg). Finding and treating compartment syndrome as soon as possible is very important. Call your caregiver if you have questions or concerns.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Activity:

At first you may need to rest in bed. Caregivers may help you elevate your limb at the level of your heart. Your caregiver will tell you when it is OK to get out of bed. Call your caregiver before getting up for the first time. If you ever feel weak or dizzy, sit or lie down right away.

Blood tests:

You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

Hyperbaric oxygen therapy:

This is also called HBO. HBO is used to get more oxygen into your body. The oxygen is given under pressure to help it get into your tissues and blood. You may be put into a tube-like chamber called a hyperbaric or pressure chamber. You will be able to see your caregivers and talk with them through a speaker. You may need to have this therapy more than once.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may be given the following medicines:

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Diuretics: These medicines will help decrease swelling in your body by making you urinate more often.
  
  
• Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach.

Tests:

You may have one or more of the following:

• Doppler flowmetry: This test checks the flow of blood in your muscles. This may help caregivers feel or hear the blood flow in the compartment.
  
  
• Magnetic resonance imaging scan: This test, also called an MRI, uses magnetic waves to take pictures. During an MRI, pictures are taken of your bones, muscle, joints, and blood vessels. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This may cause serious injury.
  
  
• Muscle compartment pressure measurement: The increased pressure within the compartment may be measured with special tools. A long needle attached to a special machine that measures pressure is put into the injured muscle.
  
  
• Near infrared spectroscopy: This test uses infrared (light beam) to show changes in the muscle.
  
  
• Scintigraphy: This is a test to look at the flow or movement of blood through the compartment area. You are given a small amount of dye in an IV. Pictures are then taken of your blood vessels, muscles, or bones.
  
  
• Urine test: A sample of your urine is collected and sent to a lab for tests. This may help caregivers know when muscles are breaking down and learn if your kidneys are affected.

Treatment options:

You may need one or more of the following:

• Brace or crutches: You may need to wear a brace to keep your limb from moving. This brace may correct, support and protect the body part. Caregivers may also give you crutches to decrease stress and strain on your leg if it has compartment syndrome.
  
  
• Surgery: Caregivers may do a fasciotomy to decrease pressure and swelling. A long incision (cut) may be done in the fascia of the injured compartments to release the pressure.
  
  
• Rehabilitation: This is a program that helps bring back your limb's normal range of motion and strength. A physical or occupational therapist may exercise your arms, legs, and hands. They may also teach you new ways to do daily activities and care for yourself. This therapy teaches you special skills for bathing, dressing, eating, or driving.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Compartment Syndrome (Inpatient Care)