Do you elevate leg with compartment syndrome?

Answered by Bruce Jewell

In my experience, when it comes to dealing with compartment syndrome, it is crucial to avoid elevating the affected leg. This might seem counterintuitive, as elevating an injured limb is often recommended to reduce swelling. However, in the case of compartment syndrome, elevating the leg can actually worsen the condition.

Let me explain why. Compartment syndrome occurs when there is increased pressure within a muscle compartment, leading to decreased blood flow and potential damage to nerves and tissues. Elevating the leg can further restrict blood flow to the affected compartment, exacerbating the already impaired circulation. This can have serious consequences, as inadequate blood supply can lead to tissue death and permanent disability if not promptly addressed.

I vividly remember a situation where a colleague of mine had a patient with suspected compartment syndrome. The patient had severe pain, swelling, and decreased sensation in their lower leg, which raised concerns about potential compartment syndrome. Our immediate response was to avoid elevating the leg and instead keep it in a dependent position, at the same level as the body, to help maintain blood flow.

In emergency situations like this, time is of the essence. Without hesitation, we made the decision to perform a fasciotomy, which is a surgical procedure to relieve the pressure within the affected compartment. This entails making incisions to release the constricting fascia and allow the muscles to expand, alleviating the pressure and restoring blood flow. The relief on the patient’s face after the procedure was palpable, and it reinforced the importance of prompt action in these cases.

When it comes to dealing with compartment syndrome, it is crucial to avoid elevating the leg. This can further compromise blood flow to the affected compartment and worsen the condition. Instead, keeping the leg in a dependent position is recommended until surgical intervention, such as a fasciotomy, can be performed to relieve the pressure and restore circulation. Early recognition and immediate action are vital in preventing long-term complications associated with compartment syndrome.