Compartment Syndrome

Compartment syndrome occurs when an injury causes the pressure to rise in a bodily compartment (e.g., a limb), thereby limiting blood flow to the muscles and nerves. If untreated, the muscles and nerves can become damaged. Depending on the severity of the compartment syndrome—acute, subacute, and chronic—amputation may be necessary. Typically there are six “Ps” associated with compartment syndrome: extreme pain, paresthesia (tingling, prickling), pallor (paleness), paralysis, pulselessness (rare), and poikilothermia (inability to maintain a constant core temperature). The most common causes of compartment syndrome include a forearm fracture, hemorrhage, vascular puncture, prolonged limb compression, crush injuries, and burns. While uncommon, compartment syndrome also can occur during labor and delivery if the birth is complicated or requires a c-section. Acute compartment syndrome requires emergency surgical intervention to release the pressure. Subacute compartment syndrome is less emergent, but still requires surgery. While not typically an emergency, the loss of circulation associated with chronic compartment syndrome can cause damage to muscles and nerves. Treatment for chronic compartment syndrome include rest, anti-inflammatory medication, and manual decompression. Elevating the limb or wearing anything that increases pressure (e.g., a splint or tight wound dressing) is not recommended. Rather, the limb should be kept at heart level and observed to ensure acute symptoms do not develop.