Compartment Syndrome

By: Karesa M. Rovnan

Many of us never heard of “compartment syndrome” until wide receiver for the Pittsburgh Steelers, Antonio Brown, was taken to the hospital after a direct blow to his lower leg while trying to make a catch last season.  Doctors wanted to make sure Brown didn’t have compartment syndrome, an orthopaedic emergency.

Compartment syndrome can occur after an injury when there is enough bleeding or swelling to cut off blood flow to the affected area.  Our muscles are held in tight compartments with limited room for expansion when swelling occurs.  If the pressure in the affected compartment gets too high, blood flowing to the muscles and nerves in that compartment will be cut off.

Once the pressure gets to a critical level, the only treatment is a surgical procedure called a fasciotomy.  A fasciotomy involves cutting the casing that holds the muscles to allow swelling to decrease and relieve pressure.

If not taken to the operating room quickly enough, a patient with compartment syndrome can suffer additional injuries including drop foot, complex regional pain syndrome, infection, tissue death or amputation.

Other professional athletes like Hakeem Nicks (Giants receiver 2010) and Marshal Yanda (Ravens guard 2012) underwent fasciotomies for compartment syndrome and were back on the field for game-time in a matter of weeks.

When examining a patient with suspected compartment syndrome a doctor must look for:

  • Pain with passive stretching
  • Tense compartment
  • Change in skin-color
  • Diminished sensation (early finding)
  • Muscle weakness
  • Complete paralysis (late finding)

The diagnosis is made primarily based upon the patient’s history and physical examination.  If compartment syndrome is suspected time is of the essence.

Is there a way to know when swelling has turned into compartment syndrome?  Doctors have tools that allow them to measure the pressure in the muscular compartment.  Once the pressure has reached a critical level (30 mmHg), the clock starts ticking.  The increased pressure causes muscles and nerves to stop functioning properly because blood flow is cut off.  However, normal function can return if blood-flow is restored by surgically relieving pressure.

Patients are often taken to the operating room without doing pressure measurements when the diagnosis is obvious from history and physical examination.

If compartment pressures aren’t monitored the only way to know whether muscle can still be salvaged is to operate.  If there is any possibility that muscle can be saved, a fasciotomy has to be performed as soon as possible.  Wasted time is wasted opportunity to save muscles and nerves.

The bottom line is – if compartment syndrome is suspected – the doctor has got to get the patient to an operating room immediately to prevent permanent, irreversible injury.

If you or a family member has suffered injury or harm due to a missed or delayed diagnosis of compartment syndrome, our medical malpractice attorneys know how to investigate and prove the facts of hospital and physician negligence, in order to obtain the maximum compensation that the law allows.

To read more about Antonio Brown’s compartment syndrome scare go to:

http://www.sandiegouniontribune.com/sports/profootballdoc/sd-sp-pfd-antonio-brown-injury-leg-steelers-1217-story.html

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