Compartment Syndrome

Compartment syndrome is an acute condition affecting the muscle compartments usually of the lower limb or forearm. It is caused by any condition that results in inflammation and swelling of the tissues inside the muscle compartments especially severe trauma. Common causes are crush injury, certain fractures and vascular injury.

The swelling results in high pressure in tissue fluid around cells and the normal flow of oxygen and nutrients from blood is interrupted. If not treated quickly by decompression using a surgical operation called fasciotomy, many of these cells will die. This is called necrosis. Death of cells results in permanent disability.

If treatment is instituted quickly there will be scarring but no disabling effects. Without treatment or delay in treatment there will be disabling effects related to death of muscle or nerve cells. In the leg there are likely to be visible changes in the appearance of the calf muscle and some movements may not be possible because the appropriate muscle or its nerve is damaged, a good example of this is foot drop. This condition may be associated with disabling and difficult to treat pain syndromes relating to ischaemic nerve damage. Any resulting disability associated with this condition is permanent and may be called post compartment syndrome.

In the arm, the most well known example of compartment syndrome is caused by fracture of the elbow in children. Acute swelling causes long term damage to the muscles and nerves of the forearm. This typically ranges from flexion contracture of the fingers to complete paralysis of the forearm wrist and fingers. Long term damage caused by compartment syndrome after elbow fracture is called ‘Volkmann’s Ischaemic Contracture’.

The effects of this condition should not be confused with exercise induced compartment syndrome.

All information must be taken into account when considering the duration of disabling effects and the duration of disabling effects must be based on the particular circumstances of the individual claimant.

Amended November 2008