Compartment+syndrome

=What is compartment syndrome?= Compartment syndrome involves the compression of nerves and blood vessels within an enclosed space. This would lead to muscle and nerve damage due to impaired blood flow. Swelling takes place in an area where the tissue has no room to expand. Pressure on arteries, veins, and nerves causes extreme pain, slows circulation to the muscles and nerves, and thus leads to potentially permanent damage. The swelling may be caused by decreased blood flow, trauma, bleeding, fluid build-up, or other factors. This disease is considered a medical emergency and requires immediate treatment to prevent permanent tissue death and dysfunction.

=What causes compartment syndrome?= Groups of muscles in the arms and legs are separated from each other by thick tissues called [|fascia]. Inside each fascia is something called a compartment, or a confined space, which holds nerves, muscle tissue, and blood vessels. Fascia is not made to expand, and thus any expansion in a compartment will lead to great amounts of pressure. If the level of pressure is high enough, blood flow to the compartment may be blocked entirely. This would lead to permanent damage of the nerve and muscle tissue. If the pressure lasts long enough, the limb may die completely and amputation may become necessary. The swelling leading to compartment syndrome may be associated with high-energy trauma. This could be from something like a car crash, or a surgery. This also could come from bandaging or casts that are too tight, and repetitive actions like running.

=What are the symptoms?= The symptoms of compartment syndrome would include: [|Sequelae] can include paralysis, nerve compression, [|contracture], or even death. The underlying tissue will feel extremely tight, and any pain will be increased with external pressure. Stretching the muscles will continue to lead to further pain. There may be decreased sensation in the skin areas provided by the nerves. A runner with this condition may find all of the symptoms relieve themselves upon rest.
 * Numbness
 * Tingling
 * Pain
 * Loss of mobility in an extremity
 * Feelings of tightness

=How is it diagnosed?= Diagnosis begins with a complete medical history and physical exam. The raised pressure can be measured using specified instruments, and the compartments can be found by moving muscles connected to them. When a connected muscle is moved, it usually results in extreme pain. The skin over the compartment will also usually be tensely swollen and shiny, and squeezing results in pain. To absolute the diagnosis, they directly measure the pressure of the compartments by using a needle attached to a pressure compartment. When the pressure level is greater than 45[|mmHg] or within 30mmHg of the [|diastolic blood pressure], the diagnosis is finalized. This test must be done as soon as compartment syndrome is suspected, so as to prevent permanent damage.

=How is it treated?= == Treatment for both [|acute] and [|chronic] compartment syndrome is usually surgery. Long [|incisions] release the pressure within the fascia, and the wounds are generally left open. They are closed around 48-72 hours later in a second surgery, sometimes involving [|sutures] or [|skin grafts]. Initial treatment usually consists of sitting with the limb elevated above the heart, and if a cast has been applied it is then removed. If a diagnosis was made immediately and treatment started, the overall prognosis for the nerves and muscle tissue is very excellent- however, the overall prognosis will be determined by the injury that lead to the syndrome.