Compartment Syndrome: Causes and Complications

In September 2020, a Tennessee car crash nearly took the lives of two young women. They were on their way home from Ohio and made it to less than one mile away from their house before they were hit head on by a drunk driver. It sent their car rolling several times down a thirty-foot embankment before finally stopping.

Fortunately, everyone in the car that hit them was okay. Unfortunately, they were not. It took nearly an hour for paramedics and emergency crews to remove them both from their vehicle, and it left them with serious injuries. As a result of the car accident, one of them now has complex regional pain syndrome and compartment syndrome.

More recently in January 2022, two workers putting down a pipeline in TN became trapped under ten feet of dirt for hours after a trench collapsed on them. A local fireman called it “amazing” that the two men came out of this alive, but they did not walk away without injuries. One was released from the hospital shortly after, but the other stayed in the hospital as they monitored him for compartment syndrome.

What is compartment syndrome?

According to the National Library of Medicine (NLM), acute compartment syndrome is a condition that typically affects the lower leg, feet, arms, or hands and requires urgent medical attention. The condition causes increased pressure within an osteofascial compartment and restricts circulation. They recommend that patients with an open fracture be monitored for compartment syndrome as the open wound is not actually relieving any pressure within the muscle compartments.

Chronic compartment syndrome also exists where the injury was not caused by an accident, but from repetitive motion. The NLM conducted a study which found that chronic compartment syndrome was often found in the lower body of runners and marching military members or in the upper body of rowers and motorcyclists. For chronic cases, the symptoms typically go away with rest and do not leave any long-lasting damage to the tissue which makes it significantly less severe than acute cases.

What causes compartment syndrome?

Acute compartment syndrome is usually caused by a severe injury, like a broken bone or a car accident about 75% of the time. However, the National Library of Medicine found that the highest risk is after a tibial fracture with between a 1% and 10% chance of compartment syndrome developing—but it can occur any time a compartment is restricted or fluid volume increases.

The National Highway Traffic Safety Administration (NHTSA) conducted a study that involved over 100,000 people who were partially ejected from a car during a crash and found that over 44,000 of those people developed acute compartment syndrome. So while this syndrome is not as widely heard of as others, it does not make it any less rare—and that is especially true for men. In another study, it was found that men were ten times more likely than women to develop compartment syndrome likely due to men having larger muscle mass. However, younger patients under the age of 35 seem to be more susceptible to it. It is believed that age groups are at a higher risk because they are more prone to injuries and accidents in general along with having tighter tissue and larger muscle mass.

When it comes to diagnosing acute compartment syndrome, healthcare professionals say there are the six P’s of symptoms:

• Pain
• Poikilothermia (inability to regulate temperature)
• Pallor (pale skin)
• Paresthesia (numbness)
• Pulselessness (faint pulse)
• Paralysis (loss of muscle function)

Compartment syndrome is officially diagnosed after measuring the pressure of an affected compartment and timely surgery is needed in order to relieve that pressure.

When it comes to chronic compartment syndrome, patients complain about a severe, localized pain often during exercise. While not all the symptoms of acute compartment syndrome appear when chronic, there are some similarities like numbness. The biggest differentiator is that patients are relieved from symptoms within a few minutes or hours after rest, but they often reappear after resuming activity.

Complications of compartment syndrome

While both acute and chronic compartment syndrome are treatable if diagnosed in a timely manner, there are some life-long complications that can follow if left untreated. In acute cases of compartment syndrome, immediate surgery that relieves pressure buildup is required. It is such a serious condition that if it is not caught and treated in time, it could result in amputation, paralysis, multi-organ failure, and sometimes even death.

If there is a delay in surgery, then irreversible nerve damage can occur and worsen with age, making it more difficult for those limbs to function properly. Sometimes the nerve damage can get so bad that cells start dying off which can lead to sepsis or losing the entire limb. If the patient is not diagnosed or surgery is not completed in time, acute compartment syndrome can very easily lead to the patient being disabled for the rest of their lives.

In chronic cases, rest is typically recommended to see if all symptoms subside even after resuming regular activities again. If symptoms come back, the NLM reported that the same pressure-relieving surgery used in acute cases has great success even in chronic cases.

If you or someone you know was injured and experienced compartment syndrome and was not diagnosed in a timely manner, then it is your right to seek out compensation for your pain and suffering. We understand the stress you and your family are going through, and we will work diligently to ensure that you have restitution and justice. Do not hesitate to call our Chattanooga injury lawyers today for help. To schedule a free consultation, call Wagner & Wagner Attorneys at Law today at 423-756-7923, or complete our contact form. We serve injured clients in Chattanooga and Cleveland, TN, and in North Georgia.