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Compartment Syndromes of the Upper Extremity

The term "compartment syndrome" refers to a condition that is characterized by severe swelling of an extremity. Limb swelling usually follows an injury, but can also occur spontaneously. When limb swelling is severe, blood supply to a limb can be reduced and cause additional damage to tissues. Compartment syndrome is a serious condition that can develop within hours and requires immediate treatment.

While a number of tests have been suggested to help diagnose compartment syndrome, the physician's examination is the most critical part of the diagnosis. Often, physicians will suggest that measurement of the pressure within an extremity is necessary to determine if a compartment syndrome could occur or already exists. Even with this test, the diagnosis of compartment syndrome is difficult to make.

Patients with a developing compartment syndrome or an established compartment syndrome will usually require a surgical procedure called "fasciotomy". The fascia is a tight, fibrous tissue that surrounds groups of muscles and stretches very little, if at all, even when pressure of the muscle inside it increases. In a fasciotomy, the surgeon makes incisions down the injured limb, releases the covering of the muscle, and opens the muscle compartment to make room for additional swelling. If the amount of swelling can be diminished and the pressure can be relieved, more muscle and nerve tissue will survive. The more tissue that can survive the injury, the better the ultimate limb function will be.

Even with this procedure, patients will often have significant, permanent dysfunction resulting from this condition. In addition to compartment syndrome, patients often have significant muscle damage from the original injury itself, further reducing the likelihood of a successful outcome.

Rehabilitation is done using cold therapy with cryo cuff units to control swelling in different parts of the body.