Crush syndrome and compartment syndrome are two different muscle disorders with similar pathophysiology. Muscles help people move and help their body function. Muscle disorders can cause weakness, pain, or even paralysis.
The key difference between crush syndrome and compartment syndrome is their cause. Crush syndrome causes organs dysfunction due to crush injuries while compartment syndrome causes painful build-up of pressure around the muscle due to severe injuries or surgery complication.
CONTENTS
1. Overview and Key Difference
2. What is Crush Syndrome
3. What is Compartment Syndrome
4. Similarities – Crush Syndrome and Compartment Syndrome
5. Crush Syndrome vs Compartment Syndrome in Tabular Form
6. Summary – Crush Syndrome vs Compartment Syndrome
7. FAQ: Crush Syndrome and Compartment Syndrome
What is Crush Syndrome?
Crush syndrome is a condition characterized by major shock and kidney failure after a crushing injury to skeletal muscles. The symptoms of crush syndrome may include breathing or respiratory issues, a drop in blood pressure from fluid loss, cardiac rhythm disturbances, blood clotting issues, pain, and psychological trauma. This condition can be caused by earthquakes, mine disasters, explosions, terrorist attacks, local wars, and other accidents.
Figure 01: Crush Syndrome and Acute Compartment Syndrome
Crush syndrome can be diagnosed through physical examination, muscle tissue biopsy, and electrocardiogram (ECG or EKG). Furthermore, symptoms of crush syndrome can be treated through administrating IV fluids, giving normal saline to dilute the toxins in the blood and protect the kidneys from damage, and providing oxygen to promote the healing of damaged tissues.
What is Compartment Syndrome?
Compartment syndrome happens when there is too much pressure around the muscles in the legs, arms, feet, abdomen, and buttocks. The most common signs and symptoms of compartment syndrome are visible bulging of muscles, muscle pain, tightness, severe pain during starching, numbness, tingling sensation under the skin, and feelings such as muscle is fuller, firmer, or bigger. Compartment syndrome occurs when an injury or repeated stress causes swelling and bleeding inside a muscle compartment. This can happen through car accidents, falling from a high place, bone fractures, crushing injuries, severe muscle contusions, complications after surgery, complications from wearing too high a cast or splint, and prolonged pressure on an arm or leg after not moving for several hours.
Figure 02: Compartment Syndrome
Compartment syndrome can be diagnosed through physical examination, X-ray, compartment pressure measurement test, and repeat pressure test. Furthermore, treatment options for the compartment disease include resting the affected muscle, taking NSAIDs or acetaminophen to reduce swelling, changing exercise routine, physical therapy, using orthotics, and performing an operation called fasciotomy.
Similarities Between Crush Syndrome and Compartment Syndrome
- Crush syndrome and compartment syndrome are two different muscle disorders.
- Both can be caused by traumas.
- Both can be diagnosed through physical examination and imaging tests.
- They can be treated through specific medications and therapies.
Difference Between Crush Syndrome and Compartment Syndrome
Definition
- Crush syndrome is a condition characterized by organ dysfunction after a crushing injury to skeletal muscle.
- Compartment syndrome is a condition characterized by increased pressure within one of the body’s muscle compartments due to severe injuries or surgery complication.
Cause
- Crush syndrome is caused by earthquakes, mine disasters, explosions, terrorist attacks, local wars, and other accidents.
- Compartment syndrome is caused by car accidents, falling from a high place, bone fractures, crushing injuries, severe muscle contusions, complications after surgery, complications from wearing too high a cast or splint, and prolonged pressure on an arm or leg.
Signs and Symptoms
- Signs and symptoms of crush syndrome include swollen muscles, sensory and motor disturbances in the compressed limbs, myoglobinuria or haemoglobinuria, oliguria with profound hypovolaemic shock, Nausea, vomiting, confusion, and agitation.
- Signs and symptoms of compartment syndrome include pain in a muscle, swelling or bulging of the muscle, feelings of numbness, weakness or pins and needles, tightness, or difficulty moving the affected body part.
Diagnosis
- Crush syndrome can be diagnosed by physical examination, blood test, urine dipstick for myoglobin, EKG, X-ray, and assessment of compartment pressures.
- Compartment syndrome can be diagnosed by physical examination, MRI scan, X-ray, and compartment pressure measurement.
Treatment
- Crush syndrome can be treated by administering intravenous fluid, giving a saline infusion of 1,500 ml/hour, providing analgesia like Entonox®, preserving body heat, oxygen therapy, diuresis, and hemodialysis.
- Compartment syndrome can be treated by using anti-inflammatory painkillers, physiotherapy, using inserts (orthotics) in the shoes, and surgery called avoid fasciotomy.
The following table summarizes the difference between crush syndrome and compartment.
Summary – Crush Syndrome vs Compartment Syndrome
Crush syndrome and compartment syndrome are two closely related clinical entities. Both arise due to trauma to muscles. This results in swelling and a compromised circulation to muscles and nerves. Crush syndrome is characterized by local tissue injury, organ dysfunction, and metabolic abnormalities due to crush injuries to skeletal muscles, while compartment syndrome is characterized by excessive pressure builds up inside an enclosed muscle space in the body due to severe injuries or surgery complications. This summarizes the difference between crush syndrome and compartment.
FAQ: Crush Syndrome and Compartment Syndrome
1. What is the cause of a crush injury?
- A crush injury occurs when the body or a body part is trapped, pinched, or jammed under or between objects. Crush injuries are more common after earthquakes, mine disasters, explosions, terrorist attacks, local wars, and other accidents.
2. How does crush syndrome cause renal failure?
- Crush syndrome is characterized by hypovolemia due to various reasons and high circulating levels of myoglobin in the plasma secondary to rhabdomyolysis. Both of these can directly cause acute tubular necrosis (ATN), which results in acute kidney injury (AKI).
3. What are the main signs of compartment syndrome?
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The main signs and symptoms of compartment syndrome are pain, pallor (pale skin tone), paresthesia (numbness feeling), pulselessness, and paralysis or weakness with movement.
4. What are the most common causes of compartment syndrome?
- Compartment syndrome can be caused by trauma such as crush injury or surgery, broken bones, bruised muscles, severe sprain, a cast or bandage that is too tight, and loss of blood supply due to the use of a tourniquet or positioning during surgery.
5. What is the best treatment for compartment syndrome?
- A surgical procedure called fasciotomy is the most effective treatment of acute compartment syndrome. It involves cutting open the inflexible tissue encasing each of the affected muscle compartment which relieves the pressure. The chronic compartment syndrome can be treated through resting, using anti-inflammatory painkillers, physiotherapy, using inserts (orthotics) in the shoes.
Reference:
1. “Crush Syndrome.” An Overview | ScienceDirect.
2. “Compartment Syndrome: Causes, Diagnosis, Symptoms, and Treatments.” WebMD.
Image Courtesy:
1. “Acute compartment and crush syndrome” By Dr.Vijaya chandar – Own work (CC BY-SA 4.0) via Commons Wikimedia
2. “Compartment Syndrome in Muscle (cleaned up) (annotated)” By Mellowchillgpt (CC BY-SA 3.0) via Commons Wikimedia
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