TRAUMA-COMPARTMENT SYNDROME

SUMMARY

1. Refers to a condition in which the pressure within a given muscle compartment is abnormally elevated.

2. Acute compartment syndrome is usually caused by significant trauma, such as a fracture or crush injury, and is a surgical emergency.

3. Chronic exertional compartment syndrome (CECS) of the lower limb is seen most commonly in running athletes.

4. Patients C/O recurrent leg cramping or pain with activities. Symptoms usually come on at a predictable time point in their exercise routine.

5. Ischemic neuropathy from high compartment pressures can occur.

6. Dx: pre-exercise pressure ≥15 mmHg, one-minute post exercise pressure ≥30 mmHg, five-minute post exercise pressure ≥20 mmHg.

7. Tx: conservative (massage, analgesia, rest) vs. fasciectomy.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].