Patients with ACS present with severe pain worsened by a passive stretch, muscle compartment tightness, paresthesia (sensory deficit/tingling), pallor (pale/pink skin) and absence or decrease in distal pulses. ACS requires urgent surgical attention to avoid permanent damage to the involved muscles. It usually follows fractures, soft tissue crush injuries, blood vessel injuries or other traumatic decrease in blood flow. Acute Compartment Syndrome (ACS) is an orthopedic emergency often associated with large increase in tissue pressure. This condition can be either acute or chronic. For more information: Acute Compartment Syndrome - Clinical Practice Guideline | American Academy of Orthopaedic Surgeons (aaos.What is Chronic Exertional Compartment Syndrome?Ĭompartment syndrome is a condition defined as increased pressure within the muscle and its surrounding tissue envelope (“fascia”) resulting in a reduced blood flow, pain, and possible muscle injury within the compartment. These are recommendations only and may not apply to every case. To assist doctors in the management of acute compartment syndrome, the American Academy of Orthopaedic Surgeons has conducted research to provide some useful guidelines. An accurate diagnosis is key to achieving a significant benefit from surgery.

Surgery for chronic exertional compartment syndrome of the leg produces excellent results in the anterior and lateral compartments, and less predictable results when the posterior compartments are involved. Also, this surgery is typically an elective procedure - not an emergency. Usually, the skin incision for chronic compartment syndrome is shorter than the incision for acute compartment syndrome. Similar to the surgery for acute compartment syndrome, the operation is designed to open the fascia so there is more room for the muscles to swell. If conservative measures fail, surgery may be an option. Changing from heel strike to toe running may modify symptoms depending on the compartments involved.Symptoms may be relieved by switching surfaces. Some athletes have symptoms that are worse on certain surfaces (concrete vs.Cross-training with low-impact activities may be an option.Your symptoms may subside if you avoid the activity that caused the condition.Physical therapy, orthotics (inserts for shoes), and anti-inflammatory medicines may be of limited benefit in relieving symptoms and generally do not allow return to full activity. Chronic (Exertional) Compartment Syndrome The incision is repaired later when swelling subsides. Sometimes, the swelling is severe enough that the skin incision cannot be closed immediately. Your doctor will make an incision and cut open the skin and fascia covering the affected compartment. There is no effective nonsurgical treatment. SymptomsĪcute compartment syndrome is a surgical emergency. This is usually relieved by discontinuing the exercise, and is usually not dangerous. People who participate in activities with repetitive motions, such as running or marching, are more likely to develop chronic compartment syndrome. The pain and swelling of chronic compartment syndrome is caused by exercise. If you have a cast, contact your doctor immediately.Ĭhronic (Exertional) Compartment Syndrome If symptoms of compartment syndrome develop, remove or loosen any constricting bandages. Casts and tight bandages may lead to compartment syndrome. Taking steroids is a possible factor in compartment syndrome. This can happen after severe intoxication with alcohol or other drugs. The development of compartment syndrome in this manner usually occurs in people whose brain function is impaired. Most healthy people will naturally move when blood flow to a limb is blocked during sleep.

Lying for too long in a position that blocks a blood vessel, then moving or waking up can cause this condition. A blood vessel can also be blocked during sleep. This may occur after a surgeon repairs a damaged blood vessel that has been blocked for several hours. Reestablished blood flow after blocked circulation.It can also happen after overly vigorous exercise that causes muscle tissue to break down (rhabdomyolysis) This type of injury can occur when a motorcycle falls on the leg of the rider, or a football player is hit in the leg by another player's helmet. Rarely, it develops after a relatively minor injury.Ĭonditions that may bring on acute compartment syndrome include:

Acute compartment syndrome usually develops after a severe injury, such as a car accident or a broken bone.

Posterior thigh compartment syndrome