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Compartment Syndrome


What is compartment syndrome?

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

What causes compartment syndrome?

  • Direct pressure: You 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.
  • Muscle overuse: Strenuous activities, such as marathon running or long distance biking, can cause compartment syndrome.
  • Medicines or IV drugs: Certain medicines, such as blood thinners, can increase bleeding or pressure in a part of your body. Medicines or IV drugs that are injected through the veins can also cause this.
  • Surgery: You may have had surgery where your leg was placed above the level of your heart for a long period of time.

What are the signs and symptoms of compartment syndrome?

  • Pain that usually increases when you stretch or bend an area
  • Swelling, tightness, or hardness of the skin in the area that was injured
  • Pale or shiny skin near your injury
  • Numbness or trouble moving your injured arm or leg

How is compartment syndrome diagnosed?

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

How is compartment syndrome treated?

If you have a cast or bandage, you may need to have it loosened or removed to decrease pressure in your muscles. You may also need one or more of the following:

  • Pain medicine: You may need medicine to decrease pain and swelling. You may need a doctor's order for this medicine. Do not wait until the pain is severe before you take your medicine.
  • 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.
  • Fasciotomy: This is a procedure where an incision is made into your injured arm or leg to decrease pain, pressure, and swelling.

What are the risks of compartment syndrome?

You may bleed or get an infection after surgery. Your muscles and nerves may have permanent damage if treatment is delayed. You may have weakness or difficulty moving your arm or leg. You may need to have all or part of the injured arm or leg removed. You may develop heart problems or kidney damage as a result of compartment syndrome.

How can compartment syndrome be prevented?

  • Elevate your injured arm or leg: Raise your arm or leg at the level of your heart as long as directed. This will help decrease swelling and pain. Do not raise your arm or leg higher than your heart. Prop it on pillows or blankets to keep it elevated.
  • Check for proper fit: Make sure your cast, brace, or bandage is not too tight.
  • Rest when needed: Rest immediately if you feel pain when you are exercising.
  • Wear comfortable shoes: Wear shoes with soft cushion, flexible soles, and low heels. Avoid running on hard surfaces.
  • Warm up before you exercise: Do warm up exercises or stretches before you exercise.

How can I manage my symptoms?

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

When should I contact my healthcare provider?

  • You have a fever.
  • You have more swelling than you did before a cast, brace, or bandage was put on.
  • Your skin is itchy and swollen, or you have a rash.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • Your cast, brace, or splint gets damaged or breaks.
  • Your pain or swelling does not go away or gets worse, even after you take medicine.
  • Your injured arm or leg turns blue or white or feels cold and numb.
  • Blood soaks through your bandage or cast.
  • Your wound is draining pus or smells bad.
  • You have chest pain, shortness of breath, or cannot think clearly.

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. 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.