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Compartment Syndrome In Children


What is compartment syndrome?

Compartment syndrome is a condition where there is increased pressure in a confined part in your child's body due to swelling or bleeding. It most often occurs in an arm or leg.

What causes compartment syndrome?

  • Direct pressure: Your child may have a bandage or cast that is too tight.
  • Injury: Any injury that causes swelling or bleeding can lead to compartment syndrome. This includes broken bones, burns, wounds, allergic reactions, or insect or snake bites.
  • Medicines: Certain medicines, such as blood thinners, can increase bleeding or pressure in a part of your child's body. Medicines that are injected through the veins can also cause this.
  • Surgery: Your child may have had surgery where his leg was placed above the level of his heart for a long period of time.

What are the signs and symptoms of compartment syndrome?

  • Pain that usually increases when your child stretches or bends an area
  • Swelling, tightness, or hardness of the skin in the area that was injured
  • Pale or shiny skin near your child's injury
  • Numbness or trouble moving the injured arm or leg

How is compartment syndrome diagnosed?

  • Blood and urine tests: Your child may need blood or urine tests to check for damage to his muscles or kidneys.
  • Doppler ultrasound: This test checks blood flow in your child's muscles. Blood flow to your child's arm or leg may be decreased in compartment syndrome.
  • MRI scan: This scan uses powerful magnets and a computer to take pictures of your child's injury. He may be given dye to help the pictures show up better. Tell your child's healthcare providers if he is allergic to iodine or shellfish. He may also be allergic to the dye. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell your child's healthcare providers if he has any metal in or on his body.
  • Scintigraphy: This test helps healthcare providers see how blood flows through your child's arm or leg. He is given a small amount of dye in an IV. Pictures are then taken of his blood vessels, muscles, or bones.
  • Compartment pressure measurement: This test uses a needle attached to a machine to check the pressure in the area your child is having pain.

How is compartment syndrome treated?

If your child has a cast or bandage, he may need to have it loosened or removed to decrease pressure in his muscles. He may also need one or more of the following:

  • Pain medicine: Your child may need medicine to decrease pain and swelling. He may need a doctor's order for this medicine. Ask how much medicine is safe to give your child and how often to give it. Do not wait until the pain is severe before you give your child his medicine.
  • Hyperbaric oxygen therapy: Hyperbaric oxygen therapy is used to put more oxygen into your child's body. The oxygen is given under pressure so his blood and tissues can receive it faster. He may be put into a tube-like chamber called a hyperbaric or pressure chamber. Your child will be able to see you and his healthcare providers and talk with you through a speaker.
  • Fasciotomy: This is a procedure where an incision is made into your child's injured arm or leg to decrease pain, pressure, and swelling.

What are the risks of compartment syndrome?

Your child may bleed or get an infection after surgery. Your child may have permanent damage if treatment is delayed. He may have weakness or difficulty moving his arm or leg. Your child may need surgery to remove all or part of his arm or leg. He may develop heart problems or kidney damage as a result of compartment syndrome.

How can compartment syndrome be prevented?

  • Help your child elevate his injured arm or leg: Raise his arm or leg at the level of his heart as long as directed. This will help decrease swelling and pain. Do not raise his arm or leg higher than his heart. Prop it on pillows or blankets to keep it elevated.
  • Check for proper fit: Make sure your child's cast, brace, or bandage is not too tight.
  • Tell your child to rest when needed: Tell your child to rest immediately if he feels pain while exercising.
  • Have your child wear comfortable shoes: Have him wear shoes with soft cushion and flexible soles. Do not let him run on hard surfaces.
  • Encourage your child to warm up before he exercises: Your child should do exercises to warm up his arms and legs before he exercises or plays sports. Ask your child's healthcare provider about the best activities for your child.

How can I manage my child's symptoms?

  • Brace or crutches: Your child may need to use crutches or wear a brace to correct, support, and protect his arm or leg.
  • Rehabilitation: Your child may need to see a physical therapist to teach him special exercises. These exercises help improve movement and strength. Physical therapy can also help decrease his pain and loss of function. An occupational therapist may help him find ways to do daily activities and care for himself.

When should I contact my child's healthcare provider?

  • Your child has a fever.
  • Your child has more swelling than he did before his cast, brace, or bandage was put on.
  • Your child's skin is itchy, swollen, or has a rash.
  • You have questions or concerns about your child's condition or care.

When should I seek immediate care?

  • Your child's cast, brace, or splint gets damaged or breaks.
  • Your child has increased pain that does not go away or gets worse, even after he takes medicine.
  • Your child tells you that his injured arm or leg feels numb.
  • Your child's injured arm or leg turns blue or white or feels cold.
  • Blood soaks through your child's bandage or cast.
  • Your child's wound drains pus or smells bad.
  • Your child has chest pain, shortness of breath, or cannot think clearly.

Care Agreement

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

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.