Working in the Operating Room was at times a frightening place to be – even for an experienced RN.
A specific incident I vividly remember was a group of college students were out one night and had car trouble. They made the fateful decision to push the car off the busy highway. While all three were pushing the car another car came speeding behind them and pinned one of the young men between the speeding car and the bumper of the student’s car. One of the students suffered severe injuries to his right leg, and he was brought to the Operating Room.
I was the RN in that room, that day. The orthopedic surgeon did all he could do at that time and the patient went to the ICU. By the next morning the patient’s right leg was red, swollen and painful. The orthopedic surgeon diagnosed Acute Compartment Syndrome. This was the first time I had witnessed this condition and surgical intervention.
WHAT IS COMPARTMENT SYNDROME?
Compartments are groupings of muscles, nerves and blood vessels in your arms and legs. These tissues are covered by a tough membrane called fascia which keeps the tissues in place and therefore the fascia does not stretch or expand easily. Compartment Syndrome is a painful condition which occurs when pressure from swelling or bleeding within the muscles builds to a dangerous level. This pressure can decrease blood flow, which deprives nourishment and oxygen from reaching nerve and muscle cells. Compartment syndrome most often occurs in the anterior (front) compartment of the lower leg (calf) but can also occur in other compartments in the leg, thigh, arms, hands, feet and buttocks.
COMPARTMENT SYNDROME – WHAT CAUSES IT AND HOW IS IT TREATED? ACUTE COMPARTMENT SYNDROME SYMPTOMS
The classic sign of acute compartment syndrome is severe pain which worsens when the muscle within the compartment is stretched. ▪ There are conditions which may cause Acute Compartment Syndrome which include:
- A fracture.
- A badly bruised muscle.
- Reestablished blood flow after blocked circulation which has occurred for several hours.
- Crush injuries.
- Anabolic steroid use – Taking steroids may be a possible factor in compartment syndrome.
- Constricting bandages – Casts and tight bandages may lead to this syndrome.
CHRONIC (EXERTIONAL) COMPARTMENT SYNDROME SYMPTOMS
Chronic compartment syndrome causes pain or cramping during exercise, most often occurs in the leg but goes away when the activity stops. Symptoms may also include:
- Numbness
- Difficulty moving the foot, with a sense of the foot slapping downward when running.
- Visible muscle bulging.
TREATMENT FOR ACUTE COMPARTMENT SYNDROME
Acute compartment syndrome is a surgical emergency as there is no effective nonsurgical treatment. The surgical emergency consists of an incision and a cut to open the skin and fascia covering the affected compartment. Sometimes the swelling is so severe at the surgical site that the skin incision cannot be closed immediately. The incision is repaired later when the swelling subsides. Sometimes a skin graft is used.
TREATMENT FOR (EXERTIONAL) COMPARTMENT SYNDROME
Nonsurgical treatment may consist of physical therapy, orthotics, (inserts for shoes) and anti-inflammatory medicines may provide limited benefit. If conservative treatment fails, surgery may be an option.
THIS INFORMATION DOES NOT PROVIDE MEDICAL ADVICE. IT IS INTENDED FOR INFORMATIONAL PURPOSES ONLY. IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY, IMMEDIATELY CALL YOUR DOCTOR OR DIAL 911.
