Compartment Syndrome
Compartment syndrome occurs when pressure within a closed muscle group rises high enough to cut off blood flow to nerves and muscles. Acute compartment syndrome is a surgical emergency; chronic exertional compartment syndrome is less severe but affects activity.
Table of Contents
Quick Facts
- ICD-10: T79.A
- Acute = emergency: Yes
- Common after: Fractures, crush injuries
Acute Compartment Syndrome Is an Emergency
Suspected acute compartment syndrome requires immediate surgical evaluation. Hallmark features (the 5 Ps):
- Pain — severe, out of proportion to injury, worse with passive stretch
- Pressure — tense, swollen compartment
- Paresthesia — numbness, tingling
- Pallor — pale skin
- Pulselessness — late finding
Types
- Acute — sudden, severe; surgical emergency. Causes: fracture, crush injury, tight cast/bandage, burns, severe muscle injury.
- Chronic (exertional) — pain with activity, resolves with rest; often in athletes' lower legs.
Diagnosis
- Clinical exam (key findings above)
- Compartment pressure measurement
- For chronic exertional: pre- and post-exercise pressure measurements
Treatment
- Acute — emergency surgical fasciotomy to release pressure
- Remove tight casts/bandages immediately
- Chronic exertional — activity modification, sometimes fasciotomy
When to See a Doctor
Severe pain after a fracture or crush injury, especially pain out of proportion or worsening despite immobilization, requires emergency evaluation. Persistent exercise-induced leg pain that consistently resolves with rest can be evaluated electively.
Frequently Asked Questions
Will a tight cast cause compartment syndrome?
It can. If you have severe pain or numbness inside a cast that doesn't improve with elevation and pain medication, contact your provider urgently or have the cast removed.
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.
References
- American Academy of Orthopaedic Surgeons. Compartment Syndrome.