Gorovitz & Borten, P.C.
Attorneys at Law

550 Cochituate Road, Suite 25
Framingham, Massachusetts
01701
Tel: (781) 890-9095
Compartment Syndrome
Compartment syndrome is a limb-threatening and ultimately a life-threatening
condition that results from a fall in perfusion pressure below tissue pressure in
a close anatomical space. Tissue perfusion is proportional to the difference
between the capillary perfusion pressure and the interstitial fluid pressure.
When the interstitial pressure exceeds the capillary perfusion pressure,
capillary collapse occurs with decreased blood flow and resulting muscle and
tissue ischemia. Prolonged tissue ischemia leads to muscle destruction
(rhabdomyolysis) and subsequent renal failure. Compartment syndrome can
affect the upper extremities as well as lower extremities or part of an extremity
(hand, forearm). The most common causes of compartment syndrome include:

  • Tibial fracture
  • Long bone fracture
  • Vascular injury
  • Compression secondary to a crush injury
  • Tight cast or dressing
  • Malposition on operating room table

The increase in compartment pressure results in decreased blood flow and
resulting ischemia. Compartment pressures of 50 mm Hg to 80 mm Hg can only
be tolerated for limited periods of time before muscle necrosis (death of
muscle tissue) occurs. Sensory abnormalities can precede motor deficiencies.
Common symptoms associated with compartment syndrome include:

  • Feeling of tightness and swelling
  • Pain
  • Pallor
  • Paresthesias
  • Paralysis
  • Pulselessness

The last five symptoms also known as the 5Ps (pain, pallor, paresthesias,
paralysis and pulselessness) are characteristic of compartment syndrome but
because they are late signs, irreversible damage may have already occurred
when they appear. A patient suffering from a compartment syndrome will
typically complain of pain that appears to be out of proportion to the injury. A
patient that suffers a compartment syndrome as a result of having been
malpositioned on the operating room table (prolonged lithotomy position for
gynecologic surgery) may not even be aware that an injury had occurred.
Clinical presentation of pain out of proportion with an injury (or in the absence
of an injury) should alert the medical provider to compartment syndrome as the
underlying cause.

Measurement of compartment pressures is the standard method for diagnosis
of a compartment syndrome. Failure to timely diagnose a compartment
syndrome results in delayed treatment with consequential damages. In acute
compartment syndrome, surgical fasciotomy to relieve the compartment
pressure is indicated. Removal of a tight cast may relieve the offending cause.
Failure to treat a compartment syndrome results in tissue necrosis that leads
to permanent functional impairment which can produce renal failure and death.
Timely diagnosis and treatment is essential to avoid loss of muscle function.
Little or no muscle function can be expected if diagnosis and treatment are
unduly delayed.

If you believe that you or your loved suffered an injury due to compartment
syndrome following a surgical procedure, have been misdiagnosed, victims of
a compartment syndrome complication or wrongly treated and suspect the
complications may be the result of a medical provider’s error that was
diagnosable, avoidable and/or preventable, you may have a valid cause of
action. The injury may be the result of a medical provider's mistake in handling
your condition and the result of medical negligence. Dr. Borten has over 35
years of experience as an obstetrician and gynecologic surgeon to fully
evaluate the merits of your potential case. Allow the Boston area medical
malpractice attorneys at Gorovitz & Borten help you assert your rights and get
the compensation you deserve.
Contact Information
For a free confidential consultation and receive a response within 24 hours
(when possible), please contact us by phone, fax or e-mail with your question
or concern.

Telephone:  781-890-9095     -     Fax:   781-890-9098
                                                                                    
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