What is one of the most important signs to watch for in compartment syndrome?

Tightness of the compartment is a critical sign to monitor in cases of compartment syndrome because it reflects increased pressure within the muscle compartments of the limb. In compartment syndrome, the pressure builds up due to factors like swelling or bleeding within a closed space, leading to decreased blood flow and, if not addressed promptly, potential muscle and nerve damage.

This tightness occurs as the muscles within the compartment become distended and the available space becomes constrained. Affected individuals may report a feeling of tightness or fullness in the limb, and this symptom can be accompanied by severe pain that does not respond well to typical analgesics. Recognizing this tightness early is essential for timely intervention, such as fasciotomy, to relieve pressure and restore normal function.

Other signs like color change in the skin, minor swelling, or joint stiffness may also accompany compartment syndrome but are comparatively less reliable indicators than tightness. Color changes can occur due to various conditions, and minor swelling alone is not definitive. Joint stiffness is more related to joint motion and may not always correlate with compartment pressures. Therefore, tightness remains the most prominent and significant sign to indicate the presence and severity of compartment syndrome.