Compartmentsyndrome Symptoms and signs
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2] ;
Overview
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.
If any of these occur, return to the Emergency Department immediately, or nearest Hospital.
Signs & Symptoms
The signs and symptoms associated with chronic exertional compartment syndrome might include[1][2][3][4][5][6][7][8]:
- Aching, burning or cramping pain in the affected limb — usually the lower leg
- Tightness in the affected limb
- Numbness or tingling in the affected limb
- Weakness of the affected limb
- Foot drop, in severe cases, if legs are affected
- Often occurs in the same compartment of both legs
- Occasionally, swelling or bulging as a result of a muscle hernia
Pain due to chronic exertional compartment syndrome typically follows this pattern:
- Begins after a certain time, distance or intensity of exertion after you start exercising the affected limb
- Progressively worsens as you exercise
- Subsides within 10 to 20 minutes of stopping the activity
- Over time, recovery time after exercise often increases
Taking a complete break from exercise or performing only low-impact activity might relieve your symptoms, but usually only temporarily. Once you take up running again, for instance, those familiar symptoms usually come back.
References
- ↑ Mars M, Hadley GP (July 1998). "Raised intracompartmental pressure and compartment syndromes". Injury. 29 (6): 403–11. PMID 9813693.
- ↑ Frink M, Hildebrand F, Krettek C, Brand J, Hankemeier S (April 2010). "Compartment syndrome of the lower leg and foot". Clin. Orthop. Relat. Res. 468 (4): 940–50. doi:10.1007/s11999-009-0891-x. PMC 2835588. PMID 19472025.
- ↑ McDonald S, Bearcroft P (June 2010). "Compartment syndromes". Semin Musculoskelet Radiol. 14 (2): 236–44. doi:10.1055/s-0030-1253164. PMID 20486031.
- ↑ Johnston-Walker E, Hardcastle J (2011). "Neurovascular assessment in the critically ill patient". Nurs Crit Care. 16 (4): 170–7. doi:10.1111/j.1478-5153.2011.00431.x. PMID 21651657.
- ↑ Suzuki T, Moirmura N, Kawai K, Sugiyama M (January 2005). "Arterial injury associated with acute compartment syndrome of the thigh following blunt trauma". Injury. 36 (1): 151–9. doi:10.1016/j.injury.2004.03.022. PMID 15589934.
- ↑ Alexander W, Low N, Pratt G (January 2018). "Acute lumbar paraspinal compartment syndrome: a systematic review". ANZ J Surg. doi:10.1111/ans.14342. PMID 29316189.
- ↑ Thati S, Carlson C, Maskill JD, Anderson JG, Bohay DR (June 2008). "Tibial compartment syndrome and the cavovarus foot". Foot Ankle Clin. 13 (2): 275–305, vii. doi:10.1016/j.fcl.2008.02.001. PMID 18457774.
- ↑ Fulkerson E, Razi A, Tejwani N (February 2003). "Review: acute compartment syndrome of the foot". Foot Ankle Int. 24 (2): 180–7. doi:10.1177/107110070302400214. PMID 12627629.