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Reality of Compartment Syndrome After a Serious Injury

| Mar 21, 2015 | Catastrophic Injuries

Auto accidents, slip and fall accidents, and other serious personal injury accidents often result in fractures. When a person suffers from a fracture to the lower leg, typically associated with a tibial fracture, it is possible to also suffer from acute compartment syndrome. Although acute compartment syndrome is most often associated with trauma to the lower leg, it can also affect those with trauma to other areas of the leg, feet, arms, and hands.

What Is Compartment Syndrome?

Compartment syndrome develops when a person sustains an injury to the body (e.g., a fracture or crush injury) that involves bleeding or swelling. When this occurs, excessive pressure can build up in an enclosed space (known as a compartment) due to blood or other fluids collecting in the compartment.

Compartments are groups of muscles, blood vessels, and nerves that are surrounded by tough connective tissues called fascia. Because fascia do not expand easily, the excessive pressure continues to rise due to the blood or fluid accumulating in the compartment. As a result, blood flow to tissues, nerves, and muscle cells is impeded. Consequently, tissue damage can occur and may even result in permanent muscle damage and loss of body function.

Symptoms of Compartment Syndrome

When blood flow is decreased due to pressure within the body’s compartments, a person will often experience great pain that is out of proportion to the injury as well as some of these other symptoms:

  • Deep ache in the affected leg or arm
  • Tingling of the skin or a pins-and-needles sensation
  • Muscle tightness
  • Swelling and bruising in the injured area
  • Numbness or paralysis once permanent tissue damage occurs

Because compartment syndrome can be life-threatening, it is critical that people with these symptoms have a thorough medical examination to determine the extent of their injuries.

Diagnosing Compartment Syndrome

If compartment syndrome isn’t caught in time or treated properly, it is possible that a person can suffer permanent muscle damage, nerve damage, and chronic pain. In some cases, paralysis or amputation may be the result. This is why it is essential that people with the aforementioned symptoms seek medical treatment as soon as possible and learn how compartment syndrome is diagnosed, including:

  • Physical exam. Any time someone suffers a physical injury, a doctor will perform an examination to determine the extent of the injury. If compartment syndrome is suspected, a doctor may conduct a passive stretch test to determine if pain is made worse by passive stretching of the muscles within the compartment. The passive stretch test will involve a patient holding the injured leg or other body part in a flexed position.
  • Pressure monitoring. If compartment syndrome is suspected, a doctor will likely insert a needle that is attached to a pressure monitor to record the pressure inside the body compartment. Gauging the pressure within the muscle compartments can also be done by inserting a catheter into the compartment for monitoring.
  • Lab tests and imaging tests. Doctors may order X-rays and other imaging tests to view the physical trauma to the bones and rule out other conditions. Also, lab tests may be conducted to see if there are elevations in the serum creatine kinase (CK). A CK test as well as other blood tests may be ordered for those who have experienced physical trauma and signs and symptoms of muscle aches and weakness.

Treatment Options for Compartment Syndrome

If a physician confirms an acute compartment syndrome diagnosis, there is no effective non-surgical treatment. In fact, emergency surgery will be necessary to relieve the pressure. This surgery is known as a fasciotomy, in which a surgeon makes long incisions in the skin and fascia in the affected compartment to release the excessive pressure. Once the swelling subsides, the incisions can be closed up and may even include skin grafting. People who have undergone this type of surgery will often be given pain medications during recovery to help reduce the amount of pain they are in.

Possible Complications Caused by Compartment Syndrome

When compartment syndrome isn’t diagnosed and treated in a timely manner and pressure isn’t relieved, several complications can arise, including:

  • Necrosis of the tissue, nerves, and muscles. Because the pressure inside the compartment is causing oxygen deprivation, affected tissues, nerves, and muscles may die. When this occurs, a person may suffer from permanent muscle and nerve damage.
  • Volkmann’s contracture. When compartment syndrome affects the hand, it can lead to a claw-like deformity. This is a permanent flexion contracture of the hand at the wrist that results in a person’s hand having the appearance of a claw.
  • Rhabdomyolysis. When muscle tissues die due to compartment syndrome, muscle fibers release a protein called myoglobin into the bloodstream which can damage kidney cells and lead to renal failure and even death in rare cases. 

If you or a loved one has experienced compartment syndrome as a result of a car accident, truck wreck, motorcycle crash, pedestrian accident, or other type of personal injury accident, it is not only important to seek immediate medical care but it is essential to seek legal counsel. Complications can arise and medical bills can spiral out of control—leaving you unable to work and in a financial crisis. You shouldn’t have to deal with the insurance company and making sure you are getting fairly compensated while trying to handle your physical pain and recovery.

At Shevlin Smith, we will fight for your financial recovery so that you can focus on your physical recovery. If you would like to discuss the specific details of your case, please call us at 703-721-4233 for a free, no-obligation consultation or contact us online to fill out a short form and we will reach out to you.