Treatment
The treatment can be causal and symptomatic. The symptomatic therapy consists primarily of pain relief, which is urgently needed in the case of compartment syndrome. This can be done with painkillers from the NSAID group.
These include ibuprofen, diclofenac or indometacin. In the case of enormous pain, painkillers can also be administered intravenously as an in-patient in hospital. However, causal therapy must be the first priority in the case of compartment syndrome of the lower leg.
A mild, initial or latent chronic compartment syndrome can possibly be treated with rest, elevation and cooling. This reduces the metabolism in the muscle, which in turn reduces swelling and bleeding and thus reduces the pressure in the muscle lobe. The alternative to conservative therapy is surgery. It is necessary in most cases of acute compartment syndrome in order to prevent serious secondary damage. The operation directly relieves the pressure in the compartment, which reduces the acute pressure and can heal the causal injury as well as damage that has already occurred.
When does one need surgery?
The surgery is necessary in most cases of compartment syndrome. The mechanism of the compartment syndrome shows that a certain pressure in the musculature sets a vicious circle in motion, whereby the pressure increases permanently until nerves and muscles die with serious consequences. For this reason an operation should be performed too early rather than too late. A slight increase in pressure can be tolerated by the muscles and fascia. However, if the pressure rises so much that the small and large veins are compressed and the oxygen-poor blood is no longer transported away, the body is no longer able to release the pressure itself and surgery must be performed as soon as possible.
Procedure of the surgery
The risks of compartmentalization are low overall. Since every surgical procedure is an injury to the anatomical structures, minor or major complications can occur. These include infections that cause superficial irritation or deep abscesses.
In addition, injuries to muscles, veins, arteries and nerves can occur during surgery on the lower leg, leading to corresponding secondary complications. The operation can also lead to new compartment syndromes. Due to the large wound, which is often only closed after the swelling has subsided, there may be pronounced scarring and contractures, which cause visual and functional problems.