Compartment syndrome is a condition that occurs when injury causes generalised painful swelling and increased pressure within a compartment of the body, to the point that blood cannot supply the muscles and nerves with oxygen and nutrients.
Muscles in the forearm, lower leg and other body areas are separated by fibrous bands of tissues into compartments and these fibrous tissues are very inflexible and cannot stretch to accommodate the generalised swelling. If left untreated, muscles and nerves fail and may eventually die.
As the compartment syndrome progresses, the structures controlled by the muscles and nerves inside the compartment may fail to function.
While most often occurring in the forearm and lower leg, compartment syndrome rarely occurs in other parts of the body that have muscles contained in compartments, including the hands and feet.
Compartment syndrome may be acute due to swelling that arises from injury, especially crushing injuries, or it may be chronic because of exertion usually from athletic exertion. It can also be caused by surgery, a severe bone fracture, or by a venomous snake or insect bite.
You may experience symptoms of compartment syndrome very soon after an injury, or even as long as a day or two later. These symptoms are usually severe and include:
• No relief from pain after taking pain medications or icing the affected region.
• Numbness, tingling, or loss of sensation in the affected region, or in your hands or toes beyond the affected region.
• Pain in the affected region.
• Pale skin in or around the affected region.
• Severe pain upon moving the affected limb.
• Tight, swollen, and shiny-looking skin over the affected area.
A number of factors increase the risk of developing compartment syndrome, but not all persons will be affected. They include:
• Involvement in a car accident or other serious trauma.
• Participation in dangerous activities that may result in traumatic injuries to the legs or arms.
• Participation in extreme endurance athletic events.
This syndrome is a serious condition and can directly result in several complications. You can help minimise your risk of serious complications by following the treatment plan you and your health care professional designed specifically for you. Complications may include:
• Amputation of the affected limb
• Muscle weakness
• Permanent muscle damage
• Permanent nerve damage.
Prevention is the first step in the treatment of compartment syndrome. Significant injuries of the arms and legs that require casting or splinting should always be elevated and iced to minimise the potential for swelling. Elevation should be above the level of the heart. Ice therapy may be considered even if a cast or splint has been placed.
Chronic or exercise induced compartment syndrome rarely requires any treatment; the pain and other symptoms usually stop minutes to hours after the activity is stopped.
However, some individuals, over time, find the chronic compartment syndrome to be very limiting, especially if it causes them to stop a favourite sport (for example, running, tennis, or football). Rarely, such individuals may have a surgeon cut open some of the fascia that comprises the compartment to reduce or stop the symptoms.
The treatment for acute compartment syndrome is surgery. The surgeon (either an orthopaedic or general surgeon) will perform a fasciotomy, an operation where the thick, fibrous bands that line the muscles are filleted open, allowing the muscles to swell and relieve the pressure within the compartment (similar to splitting open the casing of a sausage).
Depending upon the amount of swelling (edema), a second operation may be required later to close the skin after the swelling has resolved.
Once acute compartment syndrome has occurred, there is no non-surgical alternative. Hyperbaric oxygen may be considered as an adjunct treatment after surgery to promote healing.
Treatment will also be directed to the underlying cause of the compartment syndrome and to try to prevent other associated complications including kidney failure due.
Your feet mirror your general health . . . cherish them!
Leana Huntley is an English trained foot health practitioner
attached to ALMAWI Ltd—The Holistic Clinic.
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