Chronic compartment syndrome

surgical treatment and diagnosis

ompartment syndrome is a nerve- and muscle- and former compartment syndrome patient, care threatening condition which typically manifests for patients from around the world. Dr. Turnipseed is C in the lower extremities. It can be either acute considered a pioneer in treating compartment syndrome, or chronic. The acute condition results from trauma and having standardized surgical treatment for the condition in is generally treated in an emergency setting. Chronic 1980. For athletes today, UW Health offers consultation, compartment syndrome results from overuse injury where treatment and care throughout rehabilitation to help microscopic edema and hemorrhage cause excess fluid individuals suffering from compartment syndrome. accumulation in the confined space of the muscle fiber— most often in the lower leg.

At UW Health, Dr. William Turnipseed, a vascular surgeon For consultation or to schedule who revolutionized the treatment of chronic compartment a patient appointment: syndrome and Dr. Travis Engelbert, a vascular surgeon (608) 263-8915 uwhealth.org/compartment

uwhealth.org/compartment chronic compartment syndrome surgical treatment and diagnosis

Who is at risk for compartment syndrome? Common misdiagnoses With surgical treatment, small skin incisions are made Chronic compartment syndrome occurs due to overuse Many of the symptoms associated with chronic and sections of fascia are removed to release pressure. injury. It is typically seen in patients with jobs that demand compartment syndrome are consistent with other Incisions for chronic compartment syndrome are small long periods of time on their feet, or in athletes performing ailments of the lower extremities. A definitive diagnosis (two inches) and closed after fascia removal. The repetitive high impact activity. could take up to two years of enduring symptoms, procedure is generally covered by insurance. despite treatment attempts for differential diagnoses. Providers should be suspicious of lower leg pain in the UW Health Compartment Syndrome Clinic following demographics: Common misdiagnoses include: Drs. Turnipseed and Engelbert are committed to • Both male and female athletes (median age 20) • Medial tibial stress syndrome (shin splints) providing comprehensive, individualized care for patients – Runners • Stress fracture with compartment syndrome. As awareness of this • Deep vein thrombosis condition increases in both the primary care setting and – Athletes with high impact and endurance activities athletic communities, UW Health continues to attract (soccer players, track and field athletes, etc.) • Nerve entrapment and treat more patients from across the region and • Vascular disorders – Athletes who have used anabolic steroids or creatine nation. UW Health’s success rate for surgical treatment supplements causing the muscle to swell of compartment syndrome is more than 90 percent. Treatment options The surgical procedures available to treat this painful • Individuals with occupations that require long hours Treatment options can vary for each patient. While condition are simple, time-tested and effective. on their feet, e.g., first responders, mail carriers, etc a nonsurgical, conservative approach could include rest, anti-inflammatory medication and physical therapy, How is compartment syndrome diagnosed? it will likely only alleviate symptoms briefly. A surgical Often, a physical exam is unremarkable and does Diagnosis for compartment syndrome can be determined approach can deliver permanent relief and allow patients not reveal if compartment syndrome is the culprit through a quick pressure measurement which can be to return to their desired level of physical activity. of chronic lower leg pain. performed in clinic during a patient visit.

Patients with compartment syndrome exhibit a consistent, predictable and reproducible trajectory If compartment syndrome is suspected, the provider can of symptoms during physical activity. take an intracompartmental pressure measurement to confirm the diagnosis. Simple electronic compartment William Turnipseed, MD travis engelbert, MD Once the patient begins the pain-inducing exercise, measurement devices are now widely used to test they will experience: pressures. A resting pressure and a five-minute post- Dr. Turnipseed is certified by the Dr. Engelbert is fellowship trained American Board of Surgery with a in vascular surgery. Prior to joining • An increase in intensity of pain in the lower limbs exercise pressure measurement should be recorded. certificate of added qualifications UW Health, he benefitted from as they continue to perform the exercise A positive diagnosis would be represented by: in vascular surgery. He has been compartment syndrome surgery • Intolerable pain after about 20 minutes, causing • Resting pressure between 15–25 mmHg with UW Health for more than while competing as an elite athlete. the athlete to discontinue the activity 30 years and is an internationally Since joining the UW Health • Post exercise pressure > 25mmHg • Cessation of pain and tightness shortly after recognized resource on faculty, he has worked to continue compartment syndrome. He has defining protocols for treatment the activity cared for patients from across and recovery of compartment the United States and around the syndrome. world, offering them surgical relief from the condition.

To discuss a case or schedule a patient appointment, please call (608) 263-8915. CD-37932-13