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1509 Wilson Terrace
Glendale, CA 91206
Ph: (818) 409-8000






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What's the prognosis for compartment syndrome of the forearm and what can happen if it isn't treated?

Compartment syndrome describes a condition in which fluid (swelling or blood) builds up inside one or more of the individual compartments of the arm. The "compartments" are easier to understand if you think of each group of muscles and tendons as being surrounded by a protective sheath or lining of connective tissue called fascia. There are individual compartments on the front and back of the upper arm, forearm, hand, and fingers. In each compartment, the fascia fits closely to the outer layer of the soft tissue it surrounds -- like a sleeve or envelope. The structures are lubricated with a glistening fluid that allows everything to slide and glide against each other. There isn't a lot of give or room for increased volume of fluid from swelling. Traumatic injuries, especially bone fractures that puncture the soft tissues are a common cause of compartment syndrome. A splint or cast that is too tight can also cause this problem. The use of a tourniquet during surgery (or with drug abuse) can contribute to compartment syndrome. Other causes include surgery for blood clots, bypass surgery, trauma from electrical or chemical burns, crush injuries, and snake bites. Compartment syndrome is a challenging problem to work with. Early diagnosis and proper treatment are required to save the affected limb. Serious complications can occur without treatment. Without appropriate care, the patient with compartment syndrome could be at risk for death. Death of muscle tissue eventually leads to replacement with scar tissue called fibrosis. Fibrosis is stiff and unyielding. It can apply additional pressure on nearby soft tissue structures, including nerves. Tight tissues lead to contractures (muscles no longer stretch) and loss of joint motion. The final outcome can be chronic pain, loss of sensation, and loss of function. With treatment, the results are generally good. Prognosis does depend on how soon an accurate diagnosis is made and treatment started. But there are some factors that affect the final outcomes including severity of injury (e.g., damage to the soft tissues from the injury) and length of time with elevated pressures. Loss of blood supply, involvement of nerve tissue, and patient's overall general health can also make a difference. The presence of other health problems (heart disease, diabetes, blood clotting disorders) can complicate matters. There are many challenges for patients and surgeons when treating compartment syndrome. Patients with this condition must be prepared for a long course of treatment followed by months of rehabilitation. Repeated surgeries are often needed to clear out all dead tissue. Infection, poor wound healing, and open wounds in need of skin grafts further complicate recovery.

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