Symptoms | Compartment syndrome (lodge syndrome)

Symptoms

The compartment syndrome is characterized by severe, sometimes burning pain, soft tissue swelling, a marked hardening of the muscles in the affected loge and pain during passive movement caused by a lack of blood supply to the muscles.These initial symptoms are soon followed by sensitive and motor deficits in the affected area. It can also be observed that the skin over the boxes is taut and reflects. The pulses on the feet, however, are mostly retained and are not a sure sign against compartment syndrome. The toenail pressure test as a sign of compromised capillary blood flow is also not a valid indicator.

Diagnostics

In addition to the striking symptoms described above, a decisive means of making a diagnosis is pressure measurement in the tissue. Here, sensors are inserted into the conspicuous tissue and the pressure is measured. This can be done once or continuously.

The normal pressure in a healthy compartment is less than 5 mmHg, but in a manifest compartment syndrome it increases to 30-40 mmHg. The decisive factor here is the perfusion pressure of the tissue, which results from the arterial mean pressure and the pressure in the endangered compartment. If the perfusion pressure falls below 30 mmHg, the muscle is likely to die due to insufficient blood supply.

If there is a suspicion that compartment syndrome may be present, the prevailing pressure inside the muscle loge can be measured by a special device with a probe inserted from outside (intra-compartmental pressure measurement). Either a single measurement or a continuous measurement can be performed to monitor the course of the disease. However, there are no clear limits that justify the decision for or against surgery. Ultimately, the treating physician decides individually, based on the clinical assessment and all available findings, whether or when a compartment syndrome requiring treatment is present. The pressure measurement serves only as an aid and to distinguish between other clinical pictures that could be the cause of the symptoms (for example, inflammation or thrombosis).