Compartment Syndrome

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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What is the treatment for compartment syndrome?

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 minimize the potential for swelling. Elevation should be above the level of the heart. Ice therapy may even 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 favorite sport (for example, running, tennis, or football). Rarely, such individuals may have a surgeon cut open some of the fascia that surrounds the compartment to reduce or stop the symptoms.

Surgery (fasciotomy)

The treatment for acute compartment syndrome is surgery (fasciotomy). The surgeon (either an orthopedic or general surgeon) will perform a fasciotomy (see last reference for video of procedure), 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 to rhabdomyolysis.

Medically Reviewed by a Doctor on 5/19/2015
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