Compartment syndrome is a condition that develops when the pressure inside the fascia
surrounding the muscles and bone increases without relief and can cause destruction
of the capillaries and nerve cells inside. Compartment syndrome can develop in any
of the compartments in the body but is most common in the lower leg. This may develop
acutely, from an injury or other cause of immediate swelling, or chronically, as
a result of overuse or other chronic swelling.
Pain, numbness, a feeling of pressure, and some swelling usually accompany this
condition. Acute compartment syndrome is a medical emergency whereas the chronic
syndrome, although still painful and a danger to the blood vessels and nerves, can
be treated more conservatively. Both conditions must be treated, however, to prevent
permanent damage to the injured area and those distal to the injury as well.
Athletes involved in high impact collision and contact sports, such as football
and rugby, are more susceptible to acute compartment syndrome, while those involved
in repetitive activities, such as running and jumping, may be more vulnerable to
chronic compartment syndrome.
What is Compartment Syndrome?
Muscles are covered by tough fibrous tissue called fascia. This tissue wraps around
the muscles and accompanying bone and holds it all in place, forming a compartment.
The fascia is large enough to accommodate the bone, nerves, blood vessels, and muscle
at its current size. There is just enough stretch in the fascia to allow the normal
expansion of the muscle from increased blood flow due to exercise. If the muscle
swells or blood collects inside the compartment the pressure will rise. If the pressure
exceeds that of the capillaries (usually around 30 mmHG) they will begin to die.
This in turn will cause death to the nerve and muscle tissue around them due to
loss of blood supply.
Compartment Syndrome Types: Anterior and Posterior. Acute and Chronic.
Compartment syndrome is most common in the lower leg, although it can happen along
any long bone, especially with a fracture. The quadriceps muscle is another likely
candidate for this condition but due to its size and the lesser incidence of injury
it is still far less common than lower leg compartment syndrome.
In the lower leg, compartment syndrome usually involves either the anterior compartment,
over the front lateral side of the shin, or one of the posterior compartments, behind
the tibia. The posterior area consists of the superficial compartment and the deep
compartment. The lateral compartment is the fourth compartment in the lower leg.
The anterior compartment is the most commonly injured of the four compartments.