Compartment Syndrome

Basically, in the limbs, muscle groups are divided into compartments by strong fascial membranes.  Compartment syndrome occurs when increased pressure within the compartment compromises circulation and function of tissue, leading to muscle death.

Etiologies: Mainly trauma, especially with long bone fractures.  However, can occur without fractures – crush injuries, severe burns, constrictive bandages, and minor injuries.  Rhabdomyolysis can be a cause or complication of compartment syndrome – it causes it due to muscle injury leading to swelling, especially when patients are resuscitated with IVFs. 

Clinically, you should suspect this if a patient is having severe pain out of proportion to apparent injury in one of him/her limbs, also can have paresthesias and weakness, and on exam a tense compartment and pain with passive stretching of muscles. 

There is no imaging test that can definitively clinch the diagnosis; it requires placement of a catheter by the surgeons to measure compartment pressures, and treatment requires fasciotomy.

(Chanu Rhee MD, 10/14/10)