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Compartment Syndrome in the Legs

Compartment Syndrome in the Legs

If your compartment syndrome was not managed correctly by medical professionals, resulting in serious complications, you could be entitled to pursue a claim for compensation.

Commonly, such claims arise because acute compartment syndrome is not diagnosed and treated in time. Alternatively, it may be that a patient has undergone surgery for chronic compartment syndrome, but post-operative complications are not managed appropriately.

To find out if you can claim compensation for compartment syndrome, please get in touch with us today.

What is compartment syndrome?

To understand compartment syndrome, it is necessary to understand the physiology of the arms and legs.

Within the arms and legs, there are different groups of muscles. These different groups are contained by a layer of tissue called fascia, along with the surrounding blood vessels and nerves. Each contained bundle of muscles is called a compartment.

Compartment syndrome happens when the pressure inside one of these compartments increases usually due to swelling or bleeding in the muscle. Consequently the blood flow in the veins will be restricted, depriving the muscle and nerves of oxygen and nutrients. This is known as ischaemia.

Ischaemia will quickly damage the tissue, causing it to break down. If the pressure inside the compartment is not alleviated in time, the damage can be permanent, and can potentially result in serious complications such as amputation or paralysis.

Chronic and acute compartment syndrome

Compartment syndrome can either be acute or chronic.

Acute compartment syndrome develops very suddenly, usually after a traumatic incident such as a fracture of soft tissue injury. It will cause symptoms such as:

  • Intense pain
  • Skin that feels like it is burning or tingling
  • A feeling of tightness in the muscle

Acute compartment syndrome is a medical emergency as the pressure within the compartment will be extremely high. It must be treated immediately if serious complications are to be avoided.

Chronic compartment syndrome develops very gradually, usually due to repetitive exercises such as running or cycling. It will cause symptoms such as:

  • Pain and cramping during exercise
  • Bulging of the muscle
  • Difficulty moving the limb/foot

Chronic compartment syndrome is not a medical emergency and symptoms normally improve when exercise is stopped. It can be treated with conservative measures such as shoe inserts and physiotherapy.

Acute compartment syndrome in the legs

If a patient develops acute compartment syndrome in one or both legs, it is vital that the condition is diagnosed and treated as quickly as possible. As mentioned above, acute compartment syndrome is a medical emergency and surgical treatment is required within hours of the onset of symptoms.

If medical practitioners fail to provide a reasonable standard of care, there may be grounds for a medical negligence claim. This might happen, for example, if a patient presents to their GP or A&E department but a clinician fails to make an accurate diagnosis, or fails to appreciate the urgency with which treatment is needed. This can lead to life-changing complications, including amputation or paralysis.

Acute compartment syndrome and medical negligence

When a patient suffers such complications because of a substandard level of medical care, he/she is legally entitled to pursue a claim for compensation. If you believe this has happened to you, you must speak to a solicitor without delay.

Chronic compartment syndrome in the legs

Chronic compartment syndrome in the legs is a common problem for keen runners and cyclists. If such people present to a doctor complaining of pain in the shins during exercise, it would be reasonable for the clinician to diagnose 'shin splints'.

Shin splints have four main causes, one of which is high compartment pressure due to exercise. This is called chronic exertional compartment syndrome. Some clinicians will make this diagnosis based upon a patient's symptoms and history alone, while others will use a pressure manometry to confirm the diagnosis.

Chronic compartment syndrome in the lower legs can be relieved with a surgical procedure called a medial fasciotomy. This involves incising the thick fibrous envelope of muscle at the point where it attaches to the posteromedial angle of the tibia. Some surgeons will then release the fascia over the superficial compartment only, the deep compartment only, or both together. This will depend upon the preference of the surgeon.

Fasciotomy complications

A patient must be advised of the possible complications before signing a consent form, which can include neurovascular injuries and haematoma.

A haematoma can arise due to a post-operative haemorrhage from one or more sources in the leg, resulting in a blood clot forming between the superficial and deep muscular compartments in the inner aspect of the calf. This can occur because of a division of a small artery or vein, or from general post-operative 'oozing'. When this happens it is simply an unfortunate complication of surgery, and it nearly always abates at some point prior to any serious damage being caused.

If a haematoma does arise post-operatively, it must be dealt with promptly by revision surgery. A diagnosis can be confirmed through ultrasound scanning, as this will reveal a significant collection of fluid. An operation must be performed on an emergency basis or the pressure within the compartment will be raised to a dangerous level. This can cause direct compression on the muscle, and/or direct occlusion of the arterial supply to the muscle by the haematoma itself. This will result in ischaemic damage to the muscle.

If surgery is not performed quickly enough, the lack of oxygen will cause the muscle to break down and die. All the dead muscle will need to be surgically removed, potentially resulting in a large defect, something which may also affect the function of the limb.

Chronic compartment syndrome and medical negligence

Should a patient suffer surgical complications which are not diagnosed and treated promptly, there may be grounds for a medical negligence claim. If this is something to have affected you, you need to talk to a lawyer about your options.

Speak to a solicitor today

To talk to a solicitor about the care you received for compartment syndrome, please do not hesitate to get in touch with us today. We specialise in clinical negligence claims and will be able to help you further.

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