Glossary

Compartment syndrome

Quick answer

Compartment syndrome is a surgical emergency in which swelling inside a closed muscle compartment of the leg raises pressure until it cuts off blood flow to muscles and nerves. Around the knee it can follow fractures, dislocations or surgery, warns Doha knee surgeon Dr. Pablo Gelber at Aman Hospital.

What it is

The muscles of the lower leg sit in compartments wrapped in tough tissue called fascia, which does not stretch. If bleeding or swelling builds up inside, pressure rises. Once it exceeds the pressure in the small blood vessels, muscles and nerves stop receiving oxygen.

Around the knee, the commonest causes are tibial plateau fractures, knee dislocations and crush injuries. It can also follow surgery or, rarely, a tight cast or bandage.

Why it matters

Without prompt treatment, muscle and nerve damage can become permanent within hours. Warning signs include:

Pain far worse than expected for the injury, not eased by usual pain relief.
Severe pain when the toes or ankle are gently stretched.
A tense, hard, swollen calf or shin.
Tingling, numbness or weakness in the foot.

If you notice these after a leg injury or knee surgery, go to emergency care immediately. Loosen any tight dressing on the way.

How it is treated

Diagnosis is mainly clinical, sometimes supported by measuring compartment pressure with a needle. Treatment is an urgent operation called fasciotomy, in which the fascia is opened to release the pressure. The wounds are closed or grafted a few days later once swelling settles.

Frequently asked questions

Is compartment syndrome common after knee surgery?

It is rare after routine knee surgery such as arthroscopy. It is more of a concern after high-energy fractures and knee dislocations.

Can athletes get compartment syndrome?

A different, chronic exertional form causes calf or shin pain during running that eases with rest. It is not an emergency but needs assessment.