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| = [[Compartmentsyndrome Symptoms and signs|Symptoms and signs]] = | | = [[Compartmentsyndrome Symptoms and signs|Symptoms and signs]] = |
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| The 5 "P's" -- Pallor, paresthesias, pressure, paralysis, and pain on passive extension of the compartment-- are useful in recognition in the latter stages of compartment syndrome. Pain is often reported early and almost universally. The description is usually of deep, constant, and poorly localized and is sometimes described as out of proportion with the injury. The pain is aggravated by stretching the muscle group within the compartment. Paresthesia (alterated sensation e.g "pins & needles") in the cutaneous nerves of the affected compartment is another typical sign. Paralysis of the limb are usually late findings. The compartment may feel very tense and firm as well (pressure). Note that a lack of pulse rarely occurs in patients, as pressures that cause compartment syndrome are often well below arterial pressures.
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| If any of these occur, return to the Emergency Department immediately, or nearest Hospital.
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| =[[Compartmentsyndrome Diagnosis|Diagnosis]]= | | =[[Compartmentsyndrome Diagnosis|Diagnosis]]= |
| CCS can be tested for by gauging the pressure within the muscle compartments. If the pressure is sufficiently high, a [[fasciotomy]] may be required. Usually compartment pressures equal to or greater than 30mmHg implies compartment syndrome. Pressures are measured by a pressure transducer attached to a IV catheter and needle.
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| = [[Compartmentsyndrome Treatment|Treatment]] = | | = [[Compartmentsyndrome Treatment|Treatment]] = |
| Acute compartment syndrome is a medical emergency requiring immediate surgical treatment known as a [[fasciotomy]] to allow the pressure to return to normal.
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| Subacute compartment syndrome, while not quite as much of an emergency, usually requires urgent surgical treatment similar to acute compartment syndrome.
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| Chronic compartment syndrome in the lower leg can be treated conservatively or surgically. Conservative treatment includes rest, anti-inflammatories, and stretching. In cases where symptoms persist the condition should be treated by a surgical procedure, subcutaneous fasciotomy or open fasciectomy <ref>Leversedge FJ, Casey PJ, Seiler 3rd JG, et al. Endoscopically assisted fasciotomy: description of technique and in vitro assessment of lower-leg compartment decompression. Am J Sports Med 2002;30(2):272-8.</ref>. Without treatment chronic compartment syndrome can develop into the acute syndrome <ref>Mubarak SJ, Owen CA, Garfin S, et al. Acute exertional superficial posterior compartment syndrome. Am J Sports Med 1978;6(5):287-90.</ref>. A possible complication of surgical intervention for chronic compartment syndrome can be chronic venous insufficiency.
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| =[[Compartmentsyndrome Complications|Complications]]= | | =[[Compartmentsyndrome Complications|Complications]]= |
| Failure to relieve the pressure can result in necrosis of tissue in that compartment, since capillary perfusion will fall leading to increasing hypoxia of those tissues.
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| If left untreated, acute compartment syndrome can lead to more severe conditions including [[rhabdomyolysis]] and [[kidney failure]].
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| ==See also== | | ==See also== |
