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Compartment Syndrome

Compartment syndrome

Most of our muscles are divided into compartments surrounded by fascia which is not very giving (the silver skin for those who hunt). Compartment syndrome is a painful condition that occurs when pressure within the muscle compartment builds to dangerous levels.
This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.
Small nerve and muscle cells can die leading to permanent disability, weakness, and numbness.

Image
Leg on left shows section of calf that would be swollen, and a cross section of the calf shows where the anterior compartment area of muscle is located.

Classic signs and symptoms

  1. Muscle pain and cramping
  2. Swelling of the affected limb
  3. Weakness and decreased range of motion in the affected limb
  4. Tingling, burning or numbness

Two types to consider:

Non-Traumatic/Exertional

  • The pain and swelling are caused by physical exertion. People who participate in activities with repetitive motions, such as running or marching, are more likely to develop non traumatic compartment syndrome.
  • This may be relieved by discontinuing the physical activity and rest. It is commonly mistaken as shin splints in the lower leg.
  • This may become a surgical emergency and require surgical treatment.

Traumatic 

  • Caused by a variety of things:
    • Broken bone
    • Badly bruised muscle
    • Crush type injuries
    • Anabolic steroid use
    • Constricting bandages or clothing
  • Traumatic compartment syndrome is considered a surgical emergency and requires surgical treatment.

Watch Outs:

  • A swollen, painful limb that does not improve with rest can be a sign of a significant emergency and should be treated in an emergency department.
  • Any numbness or weakness in the limb should mandate transport for professional medical evaluation.

Discussion Questions:

  • Your leg is swollen and sore after a long day of physical work.  What should you do?
  • Your crew member has been resting his swollen leg for a couple hours and now says it is tingling and cramping, what are your next steps?
     
Category
Firefighter Health & First Aid
References
Compartment Syndrome in Wildland Firefighters (USFS)


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