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Patient education: Acute compartment syndrome (The Basics)
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Patient education: Acute compartment syndrome (The Basics)
Written by the doctors and editors at UpToDate
All topics are updated as new evidence becomes available and our peer review process is complete.
Literature review current through: Nov 2017. | This topic last updated: May 17, 2016.

What is acute compartment syndrome? — Acute compartment syndrome, or "ACS" for short, is a condition that causes severe muscle pain. It is an emergency that needs to be treated quickly.

A "compartment" is a group of muscles. Each muscle compartment in the body is surrounded by a strong band of tissue, called "fascia." In ACS, too much pressure builds up in a muscle compartment. This is usually caused by bleeding or a collection of fluid. The abnormal build-up of pressure damages the muscles and causes symptoms. ACS happens quickly, usually over a few hours. (The word "acute" means that something happens quickly.)

ACS most commonly happens in the forearm or lower leg (calf). But it can also happen in the foot, upper leg, or buttock.

What causes acute compartment syndrome? — Different things can cause ACS. Most often, it happens after an injury, such as a broken bone or severe burn. But it can also happen if a cast or bandage is put on too tight.

What are the symptoms of acute compartment syndrome? — Symptoms of ACS usually get worse quickly (over a few hours) and include:

Pain that is much worse than expected, given the injury

A deep ache or burning pain that doesn't go away

Numbness, tingling, or loss of feeling

If ACS isn't treated right away, it can cause other symptoms. These include muscle weakness or being unable to move certain muscles.

Is there a test for acute compartment syndrome? — Yes. Your doctor will ask about your symptoms and do an exam. Doctors usually do repeat exams over time to see if your symptoms change or get worse.

The only way your doctor can know for sure if you have ACS is to check the pressure in your muscle compartment. Doctors can use different devices to measure this pressure. But in general, this test involves putting a thin needle or tube into your muscle.

How is acute compartment syndrome treated? — The main treatment for ACS is a type of surgery called a "fasciotomy." During this surgery, the doctor will cut open the fascia and muscles to relieve the abnormal build-up of pressure in the compartment.

After surgery, the doctor won't close the cut right away. Instead, he or she will leave the cut open and bandage it loosely. The doctor will do another surgery, usually a few days later, to close the cut.

If ACS isn't treated quickly enough, muscles can die. Then people might need surgery to remove the injured body part, called "amputation."

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