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Your guide to compartment syndrome

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Compartment syndrome can often be incorrectly diagnosed as deep vein thrombosis (DVT).

If a doctor fails to provide a correct diagnosis and proper  treatment of compartment syndrome, the condition can deteriorate with further complications, which can  leave the patient suffering with permanent nerve injury and loss of muscle function.

While a bone fracture of the arm or leg  is probably the most common injury that can lead to compartment syndrome, the condition can also develop following an injury if medicines are being taken to treat or prevent blood from clotting.

Delayed diagnosis or treatment...

If you or a loved one have suffered injuries or permanent impairment caused by a delayed diagnosis and / or treatment of compartment syndrome, it is entirely natural to question why it was allowed to happen and find out what went wrong.

The answers to why there was a failure to properly treat the condition may not be straightforward and almost always needs specialist legal skills to determine liability and to hold those individuals to account.

If you  believe that you have not received  appropriate care, which may have caused unnecessary pain or left you suffering an avoidable injury you may have a  clinical negligence claim.

Our dedicated clinical negligence team at Your Legal Friend are  experienced in successfully resolving many different types and  complex cases.

We can help you find out if :

  • You were given the appropriate standard of treatment
  • You suffered an avoidable injury as a result.
  • Obtain financial  compensation for the injury or harm suffered.

What is Compartment Syndrome?

Compartment Syndrome occurs when the nerves and blood vessels are compressed within a ‘muscle compartment’ and the increased pressure leads to a restricted blood flow.

This means the condition can occur in the hand, forearm, upper arm, buttocks, leg, foot and the abdomen although most commonly the syndrome occurs in the arm or leg.

Compartment Syndrome can also be caused by:

  • External compression – i.e. overly tight bandages or plaster cast.
  • Internal compression – from internal bleeding.

There are also two main types of compartment syndrome –

Acute compartment syndrome  - following a severe injury, such as a car crash, the trauma causes an extreme rise of pressure in the compartment, resulting in insufficient blood supply to muscles and nerves.  Emergency surgery will be needed as the lack of blood supply can lead to permanent muscle and nerve damage, and the loss of limb function.

Chronic compartment syndrome - is an exercise-induced condition in which muscle pressure rises to extreme levels during exercise, reducing blood flow and depriving oxygen to the muscles.

Causes of Compartment Syndrome

The most typical injury that can lead to compartment syndrome is a fracture of the arm or leg. Fortunately, the condition does not occur after every injury to an arm or leg but you are at a greater risk if your bone is broken:

  • In your arm below the elbow, or
  • Your leg below the knee.

The risk can increase even further if an operation is needed to fix the broken bone or an infection develops in the affected limb.

 Other causes include:

  • Crush or penetration injury.
  • Bleeding from an injured blood vessel.
  • Burns.
  • Plaster casts that are fitted too tightly.
  • Intravenous medicines (via a drip), which leak inside the arm around the vein.
  • Vigorous exercise or repetitive activity.
  • Snake bites.

What are the symptoms of compartment syndrome?

Pain – is the  main symptom, which usually occurs even at rest and may also intensify during movement.

While pain is likely to be felt after any injury, in compartment syndrome the pain is:

  • Often very severe indeed.
  • Out of proportion to the injury.
  • Unable to be relieved by pain killer, and
  • Usually increases despite immobilisation.

Other symptoms in the affected limb may include:

  • Reduced sensation.
  • Paralysis, numbness or tingling.
  • Paleness of skin.
  • Feeling cold, tense or hard.
  • Weak and reduced in strength.

Diagnosis...

A correct diagnosis can present a difficulty in each case as individual clinical symptoms, which are known to be indicators of compartment syndrome, can be both unresponsive and unreliable.

Symptoms such as paralysis, which provide a definite indication, often arrive when the condition has progressed to a late stage when surgery will not lead to a full recovery.

Your doctor may suspect the condition if you have had a recent injury to one of your limbs and present the typical symptoms.

Compartment Pressure Monitoring - A specialist may also be needed to measure the pressure within the affected compartment using a special needle or an MRI scan.

Treatment...

The aim of the treatment is to relieve the pressure within the compartment surrounding the muscles. An operation called a ‘fasciotomy’ opens up the skin of the compartment and pressure is relieved.

The incision is usually left open to prevent the pressure building up again and closed using stitches some days later or left to heal by itself.

Risks of delayed diagnosis/treatment

It is crucial that prompt diagnosis and treatment takes place as early as possible. Permanent nerve injury and loss of muscle function may occur after only 12-24 hours of acute compression when the injured person is unconscious or heavily sedated, and cannot complain of pain.

Possible complications of compartment syndrome include:

  • Permanent nerve damage.
  • Permanent muscle damage and reduced function of the affected limb.
  • Permanent scarring to the limb caused by the fasciotomy procedure.
  • Loss of the affected limb.
  • Infection.
  • Kidney failure due to chemicals released by the dying muscle, which can damage the kidneys.
  • Death, in rare cases.

What are the chances of success in a negligence claim?

Compensation claims for clinical negligence are more likely to succeed in compartment syndrome cases involving:

  • Fracture of the tibia bone (in the lower leg).
  • Anterior compartment (of the lower leg) affected.
  • Deep Posterior Compartment - further compartments of the lower leg  affected.
  • Three clinical symptoms apparent at an early stage.
  • Compartment Pressure Monitoring not undertaken.
  • Claimant aged between 16-35.
  • Claimant a child or over age 35 (especially if fracture of the tibia).
  • Claimant does not report pain or other symptoms until a late stage (e.g. where patient is initially unconscious).

How Your Legal Friend can help you...

The consequences of a late diagnosis or failure to correctly treat compartment syndrome can be life-threatening and can leave a patient with a permanent impairment or severe disability.

As experienced clinical negligence specialists, our task is to ensure:

  • Your case will be properly heard.
  • A full explanation for what happened is received, and
  • Financial resources for the care and treatment needed are provided.

Your Legal Friend is committed to ensuring victims of clinical negligence obtain answers for what went wrong and receive the  compensation to cover their  needs, such as:

  • Loss of earnings.
  • Private medical care
  • Rehabilitation.
  • Care provided professionally and by family members
  • Related  out-of-pocket expenses.