CS Definition and Meaning
CD stands for compartment syndrome. Compartment syndrome is an increase in pressure in muscle tissue caused by injury or overuse, which can lead to muscle and nerve death. A distinction is made between the acute and the chronic form. Acute compartment syndrome is a life-threatening emergency and must be treated as soon as possible.
What is compartment syndrome?
Compartment syndrome is a very serious injury that definitely needs to be treated by a doctor. As a rule, certain muscles or tissues die off in the body, which can lead to considerable restrictions in everyday life and movement.
Compartment syndrome is an increase in pressure in a muscle group. It leads to reduced blood flow and impairment of nerve functions.
Muscles are surrounded by a layer of connective tissue called fascia. This combines several muscles with the same function into a muscle group called a compartment or box. The fascia is tight around the muscles and not very stretchy. If a bruise or swelling develops in such a muscle group, the pressure within the compartment increases because the enveloping fascia does not give way.
Due to the increase in pressure, nerves, tissue and blood vessels are constricted or crushed and thus damaged or even destroyed in the further course. Compartment syndrome is most common in the forearm and lower leg. A distinction is made between acute and chronic compartment syndrome. The acute form is always to be regarded as an emergency and requires immediate medical treatment.
The causes of compartment syndrome are varied. Acute compartment syndrome is most commonly caused by injuries, such as broken bones, contusions, or contusions.
This results in space-occupying bruises or edema (water retention), the fascia cannot give way and the pressure in the compartment increases. Wounds sewn too tightly or a bandage that is too tight can also trigger acute compartment syndrome.
In contrast to the acute compartment syndrome, which develops in a very short time, the chronic form develops over a longer period of time. It occurs in athletes, especially long-distance runners or bodybuilders. If the muscle is trained too hard and thus increases in volume in a very short time, the fascia cannot adapt quickly enough. This type of disease is also called functional compartment syndrome.
Symptoms, Ailments & Signs
Compartment syndrome usually does not cause any acute symptoms or symptoms. However, depending on the cause, chronic health problems can set in. Acute compartment syndrome is primarily associated with severe pain, usually associated with a feeling of tension and swelling in the affected area. In addition, there are sensory disturbances and paralysis of the muscles, whereby the symptoms of paralysis can become chronic if not treated.
Acute compartment syndrome commonly affects the lower leg and dorsum of the foot. The chronic form is also manifested by pain and feelings of tension in the affected area. It is typical of the disease that the symptoms do not appear permanently, but mainly during physical activity. At rest, the symptoms quickly subside. In addition, chronic compartment syndrome can lead to malpositions, joint wear and tear and other symptoms.
As a result of the restricted mobility, psychological complaints often arise that require independent treatment. In the long term, compartment syndrome can lead to permanent muscle damage. The quality of life of those affected is severely limited, especially in the chronic form. If the disease is treated, the symptoms usually subside or can at least be reduced to such an extent that the person affected can lead a relatively symptom-free life.
Diagnosis & History
The doctor diagnoses compartment syndrome based on the patient’s symptoms and history. The acute form causes extreme pain, as well as swelling, numbness, and tingling in the affected part of the body.
The ability to move is restricted, the skin is pale and cold to the touch. In chronic compartment syndrome, there is also clearly visible swelling in the affected muscle group. However, the symptoms only occur under stress and subside as soon as the patient is at rest. By palpating the muscles and measuring pressure with a probe, the doctor can test for compartment syndrome.
A sensitivity test of the skin reveals sensory disturbances as well as the area in which the compartment syndrome is located. Ultrasound and X-ray examinations are used as further diagnostic measures. Tissue changes can be detected with ultrasound and a possible underlying bone fracture can be seen on an X-ray.
Compartment syndrome is a very serious injury that definitely needs to be treated by a doctor. As a rule, certain muscles or tissues die off in the body, which can lead to considerable restrictions in everyday life and movement. Those affected suffer from severe pain in the muscles.
These can usually affect the entire body of the patient. The pain usually spreads to other parts of the body. Furthermore, pain at night often leads to sleep disorders and thus to general irritability due to the persistent tiredness. Compartment syndrome paralyzes muscles and creates tension throughout the body. It is not uncommon for patients to also suffer from the typical tingling sensation.
The treatment of compartment syndrome is usually causal and symptomatic. In acute emergencies, an operation can be performed. However, there is no guarantee that irreversible consequential damage will not occur. If the compartment syndrome is already chronic, the symptoms can be reduced by reducing the load. Usually there are no further complications.
When should you go to the doctor?
Chronic compartment syndrome requires diagnosis and medical treatment. Anyone who repeatedly feels muscle pain that cannot be attributed to a specific cause should consult a doctor. Restricted movement, sensory disorders and muscle weakness are other signs that indicate a serious condition and need to be treated. Acute compartment syndrome also requires medical treatment. If the patient feels severe pain or sensory disturbances in a certain area of the body, they should consult their family doctor on the same day.
Non-specific symptoms also need to be investigated if they persist for several days. So, with swelling and symptoms of paralysis, medical advice should always be sought. Compartment syndrome primarily affects extreme athletes and people who work in physically demanding jobs. Anyone who belongs to the risk groups should consult their family doctor immediately if they experience the symptoms mentioned. Depending on the type and severity of the symptoms, a sports physician, an orthopedist or a specialist in internal medicine can also be consulted. Children are best taken to the pediatrician for unusual muscle pain.
Treatment & Therapy
The chronic compartment syndrome is relatively harmless, usually a reduction in the load is enough to cause the pressure in the muscles to decrease. The affected body part should be positioned at heart level and cooled. Physical training is to be discontinued. Once the pressure situation in the muscle has normalized, you can start exercising again slowly and under medical supervision.
Acute compartment syndrome, on the other hand, must be treated as quickly as possible, otherwise tissue will die and life-threatening multi-organ failure can occur. If the increase in pressure was caused by a bandage that was too tight, it must be removed immediately. A surgical procedure called a fasciotomy is performed to reduce the pressure in the muscle compartment. An incision is made in the skin and fascia in the affected area so that the muscles can give in to the pressure and expand.
If muscle tissue has already died, it is removed. After the swelling and pressure have gone down, the fascia and skin are sutured. Skin grafts may be necessary. If nerves and muscles have been damaged by compartment syndrome, physiotherapy training can help after the wounds have healed.
Outlook & Forecast
If a compartment syndrome is diagnosed promptly, professional treatment can begin promptly. In this case, the prognosis is quite good.
Compartment syndrome is often caused by deep vein thrombosis, edema in the legs or a lower leg fracture. Only rapid treatment allows the tissue pressure and the associated circulatory disorders to be completely eliminated. Permanent damage is not to be feared in this case. The mobility of the extremities is not permanently reduced.
However, if compartment syndrome is left untreated for a long time, it can lead to a poorer prognosis. A persistent circulatory disorder in the muscles leads to the death of the surrounding muscle tissue. As a result, necrosis forms as a result of dying tissue. The scars in the affected muscles lead to more or less severe functional disorders. In the worst case, untreated compartment syndrome can lead to joint stiffness.
If left untreated, compartment syndrome can also lead to symptoms of paralysis. In this case, too, the chances of improvement are rather small. Those affected can receive physiotherapeutic treatment with these symptoms. However, this can only restore mobility in the damaged areas to a limited extent. Therefore, there can only be a good prognosis for compartment syndrome if the compression-related circulatory disorder is recognized and treated promptly.
Acute compartment syndrome can be prevented by preventing circulatory disorders and an increase in pressure. In the case of injuries to the extremities, the drainage of blood and inflammatory fluids can be promoted by elevation. A drainage, a surgically placed tube through which blood and wound fluid can drain, is also helpful. Bandages that are too tight must be loosened. Adequate training can prevent chronic compartment syndrome.
In most cases, follow-up care for compartment syndrome proves to be relatively difficult, so that in the case of this disease, a doctor should first and foremost be consulted quickly in order to prevent further injury to the muscles and thus further complications. Self-healing cannot occur. If the symptoms occur, an emergency doctor or a hospital should be contacted immediately.
In general, the affected area should no longer be loaded to allow the muscles to recover. Bed rest is to be observed, whereby those affected should not carry out any strenuous, stressful or physical activities. The position is to be shut down so that it is no longer moved.
The patients may be dependent on physiotherapy or physiotherapy measures due to the compartment syndrome. Many of the exercises can also be performed at home, which may further accelerate healing. Surgical interventions are only necessary in a few cases.
As a rule, the compartment syndrome can be treated relatively well, whereby special aftercare is no longer necessary. The disease also does not reduce the life expectancy of the affected person. Due to the illness, some patients are dependent on the help and support of friends or their own family in their everyday life due to the illness.
You can do that yourself
Whether self-help measures make sense in the case of a compartment syndrome depends primarily on the type and severity of the disease. If it is an acute compartment syndrome, those affected can usually do little themselves to relieve the symptoms. A surgical intervention is often unavoidable here.
It is different with chronic functional compartment syndrome: Here the patient should protect and cool the respective body area. Cooling promotes swelling. At the same time, however, it is advisable to promote blood circulation – for example by elevating your legs. In consultation with the doctor treating you, moderate training in the aerobic range – i.e. with a low heart rate – is possible and even conducive to healing, because the movement provides the connective tissue with an optimal supply of nutrients.
However, the patient should keep the strain on the body as low as possible, because: If the heart rate increases, as is the case with training in the anaerobic range, lactate (lactic acid) is formed. Lactic acid, in turn, leads to faster muscle fatigue and can significantly delay the healing process. The attending doctor always decides whether physical activity is an option in the individual case and if so, to what extent.