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Surgery is needed. Long surgical cuts are made through the fascia to relieve the pressure. The wounds can be left open (covered with a sterile dressing) and closed during a second surgery, usually 48 - 72 hours later. Skin grafts may be needed to close the wound.
If a cast or bandage is causing the problem, the dressing should be loosened or cut down to relieve the pressure.
With prompt diagnosis and treatment, the outlook is excellent for recovery of the muscles and nerves inside the compartment. However, the overall prognosis will be determined by the injury leading to the syndrome.
Permanent nerve injury and loss of muscle function can result if the diagnosis is delayed. This is more common when the injured person is unconscious or heavily sedated and cannot complain of pain. Permanent nerve injury can occur after 12 - 24 hours of compression.
Complications include permanent injury to nerves and muscles that can dramatically impair function. (See: Volkmann's ischemia)
In more severe cases, amputation may be required.
Call your health care provider if you have had an injury and have severe swelling or pain that does not improve with pain medications.
Twaddle BC, Amendola A. Compartment syndrome. In: Browner BD, Jupiter JB, Levine AM, Trafton PG, Krettek C, eds. Skeletal Trauma. 4th ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 13.
Geiderman JM, Katz D. General principles of orthopedic injuries. In: Marx J, ed. Rosenâ€™s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 46.
Jobe MT. Compartment syndromes and Volkmann contracture. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 71.
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