Compartment syndrome

Increased pressure in anatomical “compartment” (site where muscle and tissue bounded by fascia and bone with little space for expansion.
Fractures, crush injuries, soft tissue damage, constrictive dressing, cast or splint are the major factors that cause muscle and nerve damage. In pathogenesis anoxia, acidosis, venous, arterial obstruction and edema leading to muscle and nerve necrosis and as result excruciating pain, swollen limb, numbness and paralysis (inability to move limb) occur.

Clinical application of HBO:

Prevents progression and further damage by increasing oxygen tension in anoxic tissue
Relieves pain
Reduces edema by vasoconstriction
Decreases chance of infection in necrotic muscle
Provides better microcirculation
Enhances post-surgical recovery and reparation of nerve and muscle

Further reading:

Bouachour G Hyperbaric oxygen therapy in the menagement of crush injuries: A randomized Double- blind placebo-controlled clinical trial, The journal of trauma; 1996 41(2) 333-339
Haapaniemi T Hyperbaric oxygen reduces ischemia-induced skeletal muscle injury. Discussion with William A. Zamboni, Plast Reconstr Surg; 1996, vol 97, 608-609
Nylander G Plast Reconstr Surg Reduction of postischemic edema with hyperbaric oxygen, Plast Reconstr Surg1985 vol76, 596-603
Schroeder HP Crush syndrome of the upper extremity, Hand Clin; Aug 1998, 14(3) 451-6
Shupak A Hyperbaric oxygenation in acute peripheral post-traumatic ischemia, J Hyperbaric Med 1987; 2:7-14
Skyhar MJ Hyperbaric oxygen reduces edema and necrosis of skeletal muscle in compartment syndromes associated with hemmorhagic hypotension, J Bone Jt Surg 1986; 68A: 1218-1224
Strauss MB Delayed use of hyperbaric oxygen in a model compartment syndrome, J Bone Jt Surg 1986; 65A:656-662
Strauss MB Hyperbaric oxygen and skeletal-muscle compartment syndrome, Contemp Orthop 1989; 18:167-174

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