When Fascia gets too tight: Compartment Syndrome

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 Case Study: Acute Compartment Syndrome

22 year old male basketball player accidentally takes a knee in the thigh during a game, a fairly common injury in basketball. He stops playing and ice’s his knee. The next day, his leg is noticeably swollen and becoming painful. He has a desk job and during the next day, his leg becomes very hard, swollen and painful. He goes to the E.R. and they immediately perform a limb saving surgery, a fasciotomy, which is when the skin and fascia around the affected compartment is cut to release pressure. What exactly happened to the tissue?

Without becoming too complicated, Acute Compartment Syndrome is when the pressure in the muscle rises to dangerous levels usually as a result of trauma. Acute Compartment Syndrome is a medical emergency as the pressure can rise to a point of permanent muscle damage as blood flow is decreased as the swelling increases within the fascial compartments of the leg. If the blood supply is compromised long enough, tissue death can occur.

What to look for if you think you may have Acute Compartment Syndrome:
1. The pain and swelling is greater than the level of trauma or injury that occurred.
2. Using or stretching the muscles involved is very painful
3. Possible numbness or tingling can occur
4. Severe sense of muscle tightness or “fullness” in the effected areas

If you suspect an Acute Compartment Syndrome, you must seek medical attention immediately, The medical staff will then check the pressure and act accordingly. Hopefully you will never be confronted with this, but it’s good to know what to look for just in-case.

~Ed Deboo, Physical Therapy, Bellingham, WA

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