Definition: What is Compartment Syndrome?

“Chronic compartment syndrome is a pathology that mainly affects athletes practicing endurance sports such as the running“, explains Dr. Pierre Diviné, orthopedic surgeon. The muscles of the limbs are placed in determined spaces, sorts of compartments called lodges. It sometimes happens that the pressure inside these compartments is too highin particular following a intensive or inappropriate training. This pressure causes a increase in muscle size (hypertrophy). It is this hypertrophy that is responsible for the pain felt most often in the forearm or leg. “There are two distinct forms of compartment syndrome. There acute form, most often post-traumatic, whether or not associated with a fracture; there chronic and intermittent form, triggered by effort”. Compartment syndrome is difficult to diagnose. “Treatment is most often surgical.

What part of the body is affected by Compartment Syndrome?

“Compartment syndrome can affect both the lower limbs than upper limbscontinues the specialist. It is found more frequently in the lower leg (calf, shin) and forearm. However, it can affect other areas: feet, thighs…“.

What are the symptoms of Compartment Syndrome?

“The signs of compartment syndrome are quite characteristicassures the doctor:

• Of the pains very intense;
• Of the hard and tense muscles;
• A swelling and a feeling of pressure in the muscle compartments concerned;
• A pulse which usually remains palpable.

What is the cause of Compartment Syndrome?

There are therefore two forms of compartment syndrome:
► “There acute form, which is a surgical emergency“, details our interlocutor. It most often follows a trauma : fracture, severe contusions or muscle compressions, bandage or cast too tight“.
► “For its part, the chronic formis intermittent and mainly concerns athletes who overwork their muscles. It is spontaneously reversible when the effort is stopped.“.

“Acute compartment syndrome follows a clinical diagnosis not requiring additional examination, answers the specialist. While chronic compartment syndrome is confirmed by measurement of muscle pressure at rest, then compared to those measured after effort“.

What is the treatment for compartment syndrome?

“In some cases, a surgical treatment is offered to the patient, recalls Dr. Diviné: it consists of a aponeurotomy next to each lodge concerned allowing a complete release of the muscular structures. This is most often performed by a minimally invasive way under endoscopy (using a camera)”. Chronic compartment syndrome is usually not dangerous. “By requiring less muscle (by ceasing sporting activity for example), we will be able to reduce the pressure exerted in the muscular compartment. The patient can then return to sport gradually and then adapt it“.

When to operate on Compartment Syndrome?

“In the case of compartment syndrome acutethe treatment is always urgent and surgical, concludes our interlocutor. But in the context of a compartment syndrome chronic stress, surgical treatment is proposed to the patient when the pain is the cause of a significant functional limitation”.

Thanks to Dr Pierre Diviné, orthopedic surgeon at the CHP de l’Europe de Port-Marly (Vivalto Santé Group).