No matter how many definitions of this I read, I don’t grasp what it is.
In: Biology
Best described with an example.
An injury to a persons leg causes swelling. The swelling is extreme and compresses the blood vessels in that area. As a result, blood can no longer travel through this area to the foot. This is compartment syndrome. The compartment part is named because the limb past the injury is an enclosed compartment that is now separate from the rest of the body and cutoff from the body’s blood supply. If the blood supply is not returned (by treating the swelling) the foot will die and may need amputation.
Obviously this is just one example of how it happens and there are many others. But its compartment syndrome is most common in trauma for the reasons above.
There are two categories of compartment syndrome – acute and chronic. The acute type happens rapidly after an injury, such as a fracture, a crush injury, or a burn, and the chronic type is repetitive, multiple episodes over time. The acute type is really, really bad, and the patient needs to go right to surgery. Chronic, not so bad, but still requires treatment.
Compartment syndrome is named after the fact that the muscles in your extremities are divided by sheets of fascia into different compartments. If you’ve ever seen a deer skinned, fascia is the silvery, almost see-through covering over the muscles. It exists not only on the outside of the muscles, but also runs between them. Between compartments, that fascia is tough and cannot expand if the pressure rises in that compartment. Acute compartment syndrome can occur from bleeding into the compartment (fracture, crush injury), or swelling from fluid leaking out of blood vessels (burns). Chronic compartment syndrome occurs with exercise, so it’s called chronic exertional compartment syndrome (CECS) because, well, you get it from exertion. Some people do, that is. For unknown reasons, some people’s muscles swell more with exercise, which raises the pressure within the compartment the swollen muscle resides in.
The result of increasing pressure within a compartment is that smaller blood vessels are compressed, and so oxygen cannot get to tissues (such as muscle), since the blood has to reach the capillaries (the smallest of blood vessels), where the oxygen enters tissues. Compartment syndrome is extremely painful. In CECS (chronic), the pain causes the person to stop exercising, and the muscle then shrinks back down to normal size, and blood flow is restored. Then they exercise again, and the cycle repeats. CECS typically does not cause muscle damage, although I had one case in which it did cause mild damage, which was noticed at surgery. It was thought that the patient’s pressures were particularly slow to drop after stopping exercise, so the muscles were exposed to a longer than usual period of high pressure.
In acute compartment syndrome, there is nothing that can decrease the pressure, other than surgically opening the compartment by slicing the fascia. It’s considered an emergency, and you have about 8 hours to do this after onset of, otherwise the affected muscles will die from lack of oxygen. In CECS, you can still slice the fascia to treat it, but it’s an elective surgery, not an emergency.
Diagnosis is accomplished by inserting a needle that is connected to a digital pressure gauge into the compartment and taking a reading. I use ultrasound guidance when I do this, so I can be sure of which compartment I am testing and also avoid blood vessels and nerves with the needle.
source: I’m a sports medicine doctor
Muscles are made of lots of strands of muscle fibers. They’re contained by a tough membrane that holds them together, so the membrane forms a tough compartment for each muscle. If you tear the muscle enough to bleed, the blood has nowhere to go, so it collects and puts so much pressure on the muscle that no more blood can get in and out. No blood, no oxygen, no nutrients, just tissue death progressing to gangrene if the pressure isn’t relieved. A pressure measuring device on the end of a needle can diagnose it, then the membrane has to be split to relieve the pressure before the gangrene sets in. You can lose a limb this way if not treated.
Eli5: Your leg, for example, has two expandable tubes in it. One has blood flowing and the other one has everything else in it. Normally both are lightly inflated and things flow in and out and everything is ok. If the one without blood starts to expand (too much of everything else), it squeezes the one with blood and stops the flow of blood. This is compartment syndrome. This is very bad and you need to burst the one with everything else to get the blood flowing again.
It’s a bit more nuanced than that, but you’re only 5.
Latest Answers