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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes A Compartment Syndrome While Suffering From Hematoma?

Hi, I was kicked by a horse on the medial side of my R lower leg (tibia and calf). It caused a tennis ball sized hematoma but I have been treating it with NSAIDs, ice, elevation. No obvious deformity. It has been 48hrs and is still a bit painful to walk on, but at least the hematoma is decreasing as it is spreading down my leg, but is still red in color. I have a good amount of tightness, no paresis or parenthesis. I know radiographs would give a definitive diagnosis, but was wondering if I should be concerned about the erythema (re-bleeding?) and location of the injury (compartment syndrome)?
Thu, 9 Jul 2015
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Diabetologist,  's  Response
Hi,

Thanks for your question.

After going through your question, I can understand your concern.

Compartment syndrome :
- Soft tissue like muscles, fat, Nerves, Blood vessels are kept together in a compartment made up of fascia.
- Whenever there is soft tissue injury as in your case, there is swelling over soft tissues, this swelling can increase upto certain extent without increasing pressure inside compartment limited by fascia but after that there may be rise in pressure which causes compression of nerves and blood vessels which is called as compartment syndrome.
- You should predict possibility of compartment syndrome if there is
* Sudden increase in severity of pain and
swelling .
* Development of numbness or altered
sensation over part distal to site of injury.
* Change in skin color or unable to feel
pulsations of blood vessels distal to site of
injury.

Possibility of rebleeding may be there if there is injury to major blood vessels.
In case of rebleeding there is increase in size of swelling and pain.

Xray will help in evaluation of bony injury.

If tthere is infection again it may present as increase in size of swelling and pain.

Use of pain killer with serratopeptidase and antacids may help. Antibiotics may required depending upon clinical evaluation.

It is advisable to consult orthopedic surgeon.

Hope this helps you, if so do vote as helpful.


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What Causes A Compartment Syndrome While Suffering From Hematoma?

Hi, Thanks for your question. After going through your question, I can understand your concern. Compartment syndrome : - Soft tissue like muscles, fat, Nerves, Blood vessels are kept together in a compartment made up of fascia. - Whenever there is soft tissue injury as in your case, there is swelling over soft tissues, this swelling can increase upto certain extent without increasing pressure inside compartment limited by fascia but after that there may be rise in pressure which causes compression of nerves and blood vessels which is called as compartment syndrome. - You should predict possibility of compartment syndrome if there is * Sudden increase in severity of pain and swelling . * Development of numbness or altered sensation over part distal to site of injury. * Change in skin color or unable to feel pulsations of blood vessels distal to site of injury. Possibility of rebleeding may be there if there is injury to major blood vessels. In case of rebleeding there is increase in size of swelling and pain. Xray will help in evaluation of bony injury. If tthere is infection again it may present as increase in size of swelling and pain. Use of pain killer with serratopeptidase and antacids may help. Antibiotics may required depending upon clinical evaluation. It is advisable to consult orthopedic surgeon. Hope this helps you, if so do vote as helpful.