Compartment syndrome

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Wrist anatomy

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Compartment syndrome

Treatment for both acute and chronic compartment syndrome is usually surgery. Long incisions are made in the fascia to release the pressure building inside. The wounds are generally left open (covered with a sterile dressing) and closed during a second surgery, usually 48-72 hours later. Skin grafts may be required to close the wound.

If a cast or bandage is causing the problem, the dressing should be loosened or cut down to relieve the pressure.

If the diagnosis of compartment syndrome is made promptly and surgical release performed, the outlook is excellent for recovery of the muscles and nerves inside the compartment. However, the overall prognosis will be determined by the injury leading to the syndrome.

If there is a delay in diagnosis, there can be permanent nerve injury and loss of muscle function. This is more common when injured person is unconscious or heavily sedated and incapable of complaining. Permanent nerve injury can occur after 12-24 hours of compression.

Complications include permanent injury to nerves and muscles that can dramatically impair function. (See Volkmann's ischemia.)

In more severe cases, limbs may need to be amputated because all the muscles in the compartment have died from lack of oxygen.

If you have suffered an injury and have severe swelling and/or pain that does not improve with pain medications, contact your health care provider to be evaluated for compartment syndrome.

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