Exertional Compartmental Syndromes

Abstract

Compartmental syndrome denotes a condition in which an increase in the volume of tissues in an anatomically closed space results in an abnormal rise in tissue and intracompartmental pressure that compromises the circulation and the function of tissues in that space [1]. Exertional compartmental syndrome indicates that the mechanism of increased intracompartmental pressure involves exercise. Acute and chronic exertional compartmental syndromes have been described. In acute syndromes the pathological rise in intracompartmental pressure that is the central mechanism of the syndrome is attributable primarily to muscle injury with subsequent tissue swelling occurring as a consequence of muscle necrosis and edema. Patients with inborn errors of muscle energy metabolism who are subject to recurrent exertional rhabdomyolysis are liable to recurrent acute compartment syndrome. In individuals with chronic exertional compartment syndrome, an abnormal rise in intracompartmental pressure accompanies physiological fluid shifts that are induced by metabolic and hydrostatic effects of exercise [2]. The exaggerated rise in compartment pressure presumably results from a “tight” compartment in relation to the degree of tissue expansion.