Compartment syndrome

Compartment syndrome (sometimes known as compartmental muscle compression syndrome) refers to an increase in pressure within one of the body’s muscle compartments. This kind of pressure build-up is a medical emergency and must be treated immediately. If left untreated, the increased pressure can cause the tissue within the muscle compartment to die (necrosis).

The muscles are divided into individual sections (fascial compartments) by sheets of connective tissue known as fasciae. If there is increased pressure on the muscles in these compartments, it is called compartment syndrome. This syndrome is generally caused by soft tissue injuries that occur when a bone is broken, or if the muscles receive a major physical blow. Such injuries can result in bleeding and swelling within a muscle compartment. Given that the muscle compartment is surrounded by fasciae, this prompts an increase in pressure inside the affected compartment. The pressure prevents venous blood from flowing away from the area. This further increases the pressure, so that eventually the arterial blood vessels also become cut off. The resulting circulatory defect in the muscles leads to tissue damage (necrosis).

In rare cases, athletes can inadvertently trigger compartment syndrome by overexerting their muscles. Intense muscle use (e.g. running a marathon, body building) causes myoedema, which can sometimes lead to what is known as functional compartment syndrome – a variation of the condition that is not associated with any kind of injury.

The main symptom of compartment syndrome is very strong pain in the affected muscle. The pain is so severe that it usually cannot be sufficiently relieved using regular pain killers. It is accompanied by a feeling of tightness in the affected muscle area and sensory disorders such as a tingling sensation or numbness. Compartmental muscle compression syndrome most frequently occurs in the calves, forearms or feet. Occasionally the condition can develop after an operation.

The diagnosis is made on the basis of the symptoms and an examination of the affected limb.

Functional compartment syndrome resulting from overexertion can normally be healed within one or two days by cooling and resting the muscles.

In contrast, compartment syndrome resulting from an injury is an emergency and requires immediate surgery. A procedure known as a fasciotomy is performed to open the affected muscles and reduce the pressure. The surgical wound is only closed once the pressure has normalised and the tissue has recovered.