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swatsurgeon · 07-21-2005, 06:16

Big Chief,
I think I know what you are asking.....but let me ramble on the subject.
The lower leg has 4 compartments; they each contain a set of the muscle located in the lower leg. Each compartment is separated from the others by investing fascia and bone. When a muscle swells, becomes edematous, there is only so much room to accomodate the increased muscle volume. When the limits of volume have been exceeded, a compartment syndrome can, and usually does, occur. This is manifest by
1) pain
2) pain with stretching of involved muscles
3) changes in sensation
4) pallor: whiter (ischemic) appearance
5) sense of cooler extremity (decreased blood flow)
6) eventual paralysis
This can lead to loss of limb.
The treatment is a compartment release which is simply removing the barrier to expansion of the muscle group. We split the fascia which "breaks open" the compartment and allows the sweeling to occur and not be 'held back'. Theoretically, if it is caught early and there is no muscle or nerve cell death, there should be no long term disability. If the muscle bulged A LOT past the anatomic margins of the compartment, sometimes a skin graft is needed to now cover the permanently exposed muscle. Generally, with no significant damage, there should be unrestricted activities.

ss

07-21-2005, 06:16	#13
swatsurgeon Guerrilla Chief Join Date: Jul 2004 Location: Phoenix, AZ Posts: 880	Big Chief, I think I know what you are asking.....but let me ramble on the subject. The lower leg has 4 compartments; they each contain a set of the muscle located in the lower leg. Each compartment is separated from the others by investing fascia and bone. When a muscle swells, becomes edematous, there is only so much room to accomodate the increased muscle volume. When the limits of volume have been exceeded, a compartment syndrome can, and usually does, occur. This is manifest by 1) pain 2) pain with stretching of involved muscles 3) changes in sensation 4) pallor: whiter (ischemic) appearance 5) sense of cooler extremity (decreased blood flow) 6) eventual paralysis This can lead to loss of limb. The treatment is a compartment release which is simply removing the barrier to expansion of the muscle group. We split the fascia which "breaks open" the compartment and allows the sweeling to occur and not be 'held back'. Theoretically, if it is caught early and there is no muscle or nerve cell death, there should be no long term disability. If the muscle bulged A LOT past the anatomic margins of the compartment, sometimes a skin graft is needed to now cover the permanently exposed muscle. Generally, with no significant damage, there should be unrestricted activities. ss __________________ 'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that. (adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 ) Education is the anti-ignorance we all need to better treat our patients. ss, 2008. The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
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