Compartment Syndrome of the Hand
Compartment syndrome occurs when blood flow to the muscles and nerves is blocked as pressure in a muscle compartment increases. This causes swelling and increased pressure in the small space, or compartment, around the muscle. In the hand, compartment syndrome can cause severe pain as well as muscle weakness.
Compartment syndrome of the hand is not as common as compartment syndromes of the forearm and leg, but it is not rare by any means. If not treated it can lead to serious, long-term adverse effects.
In this article, Detroit area board certified hand surgeon Dr. Uzma Rehman explains the causes and the treatments available to patients with compartment syndrome of the hand.
Causes of Compartment Syndrome of the Hand
Compartment syndrome can develop in the hand from a wide variety of causes that either reduce the size of the compartment, or increase the volume of fluid in the compartment, or both
The most common causes of compartment syndrome in the hand are crush injuries, fractures, and burns. Snake bites, hemophilia, intravenous or intra-arterial injections, and local anesthetic blocks can all cause compartment syndrome. Less common causes of compartment syndrome include compression dressings, excessive exercise, and intrauterine umbilical cord strangulation in a fetus.
Symptoms of acute compartment syndrome include severe muscle pain, numbness or tingling, a feeling of tightness in the muscle, pale or shiny skin tone in the affected area. Compartment syndrome caused by a traumatic injury such as a broken bone requires immediate treatment, and patients should go to the nearest emergency room immediately.
Treating Compartment Syndrome of the Hand
Early diagnosis and treatment of compartment syndrome is the key to facilitating full functional recovery. The hand surgeon will perform a surgery called a fasciotomy to relieve pressure in the affected muscle compartment and prevent further damage to muscles and nerves.
The good news is that fasciotomy surgery is almost always successful as long as it is performed promptly. However, if treatment is not received within 12 to 24 hours of the onset of symptoms, permanent muscle and nerve tissue damaged can occur – in addition to a complete loss of muscle function requiring amputation in rare cases.
Fasciotomy Surgery for Compartment Syndrome of the Hand
Fascia are the thick sheets of connective tissue that surround the compartments where the muscles are. During fasciotomy surgery, this fascia is cut to relieve pressure in the muscle compartment and increase blood flow to muscles and nerves.
Local or general anesthesia may be used. And more than one incision may be required if multiple muscles are affected. Once the swelling goes down, the hand surgeon closes the incision. And in many cases the patient does not need to stay in the hospital overnight.
In severe cases of compartment syndrome, the hand surgeon may use a skin graft – healthy skin from another part of the body – to cover the area and help it heal. A skin graft can also provide more space in the affected compartment, decreasing the risk of a recurrence.
What to Expect After Compartment Syndrome Hand Surgery
During the first days after surgery, the injured hand or arm should be immobilized or elevated, with absolutely no weight put on the affected limb. A post-op exam is usually scheduled within the first week to ensure proper healing. After 10 to 14 days, the hand surgeon will remove the stitches or staples used to close the incision. Once the incision heals, our skilled physical therapists begin PT to rebuild strength, flexibility, and range of motion in the hand.
With prompt surgery in the hands of a skilled surgeon, most people who undergo fasciotomy surgery avoid serious complications in the affected muscles and nerves and will recover completely.
Top Hand Surgeon | Compartment Syndrome | Detroit Area
If you are suffering from a compartment syndrome -or any other condition in your fingers, wrist, elbow, or arm, that requires surgery – contact top Detroit area board certified hand surgeon Dr. Uzma Rehman for a comprehensive evaluation and consultation.
Choosing a skilled and experienced board-certified hand surgeon is the best way to ensure that you preserve or restore full use, mobility, function and sensation to your injured hand, wrist or arm.
