Q: I recently injured my lower leg badly. In doing some research, I came across the term “compartment syndrome”. What is that?
Compartment syndrome takes place when some form of trauma has occurred in one of the lower extremities. A lot of trauma can happen without compartment syndrome developing, but the thought does cross the mind of many ER physicians or orthopedists when someone suffers a severe injury to the lower leg.
To understand compartment syndrome, we first need to review the anatomy of the lower leg. Within the lower leg, there are three compartments that divide the area lengthwise between the ankle and knee. These compartments are made of tough, non-stretching tissue called fascia. These compartments contain muscles that have blood vessels and nerves to help them function.
If blunt force trauma such as a motor vehicle accident or a very heavy object smashes a leg, swelling can occur. Within the compartments of the lower leg, there is no room for swelling and this will cause pressure on the muscles, blood vessels and nerves. Some swelling of the lower leg can be tolerated, but as the swelling increases, it creates a rising pressure in one or more of the three compartments. This increased pressure in these compartments compresses the blood vessels and nerves. This in turn causes loss of nerve functions and muscle damage. If the situation is not addressed quickly, it can lead to permanent nerve and/or permanent muscle damage.
Compartment syndrome involves a history of blunt trauma followed by swelling and pain out of proportion to the appearance of the injury. The muscle of the lower leg will be firm and tense. Moving of the ankle usually causes increased pain. Numbness in the foot is a sign that permanent damage may already be taking place.
Treatment starts with early recognition of the symptoms. This will usually happen in the emergency room. Some ERs have the capability of testing the pressure inside the compartments of the lower leg to confirm the diagnosis of compartment syndrome. If the condition is positively diagnosed, the patient will be taken for emergency surgery to open the compartments of the leg. The incision is allowed to remain open for several days after which it will be closed when the swelling subsides.
Compartment syndrome doesn’t happen with every car accident, football tackle or fracture. It is something however that can cause lasting adverse results if not recognized and treated appropriately.
Dave Stoll, PA-C
Orthopedic Care in the office of Jon Orjala, D.O.
Utica Park Clinic – Owasso
10512 N. 110th East Ave., Suite 220
Owasso, OK 74055
918.376.8959
