Crush Injuries (Compartment Syndrome)

Compartment syndrome is a condition which results when the pressure inside a given anatomic compartment or location becomes so great as to cause normal blood flow to cease. This can result in severe pain, and if left untreated can lead to severe muscle and nerve damage, and can result in the loss of the affected limb or organ. Due to the build-up of chemicals released by dying muscle cells another concern is damage to other organs, such as the kidneys.

Common causes of compartment syndrome include the abnormal presence of fluid (usually blood) inside of the compartment. This commonly is a result of severe blunt force trauma that has damaged deep tissues and blood vessels, but which has left the skin intact. The blood has nowhere to go so it builds up in the tissue causing the decreased blood flow.

Injuries that may lead to compartment syndrome include blunt force trauma (such as a foot being run over by a fork lift), and fractures of the bones of the leg and the heel bone.

Symptoms to watch out for compartment syndrome in the foot and leg include a cool to cold limb with no pulses, extreme pain un-relieved by pain killers, numbness and/or tingling, and a bluish tint to the skin and toes.

This condition when it is most acute is most commonly treated with a procedure called a fasciotomy, which is the surgical opening of the compartment, to allow for adequate drainage of fluid and to allow blood flow to resume. This may take place concurrent with procedures to set any broken bones that may have occurred. The incisions may be partly closed or left fully open depending on the severity of the issue.

A more low grade chronic version of compartment syndrome is also possible in those with exceptionally toned physiques, as muscles can become developed to the point that the connective tissues containing them are insufficient, and thus exercise or physical activity can induce compartment syndrome. This version can usually be managed conservatively via activity modification. It will have similar symptoms to those induced by trauma.