![]() This article will focus primarily on acute compartment syndrome.Īcute compartment syndrome (ACS) is a surgical emergency, most commonly secondary to significant trauma such as a long bone fracture. When perfusion can no longer meet the demands of the tissue, necrosis ensues. If the pressure increase continues untreated, irreversible damage to the muscles and nerves within the compartment ensuesĬhronic compartment syndrome is most commonly seen in athletes and presents as insidious pain. As a result of reduced arteriovenous pressure gradient, there is decreased tissue perfusion. Thus, any condition that increases the content or reduces the volume of a compartment could be related to the development of compartment syndrome.Ĭompartment syndrome occurs because intra-compartmental pressure rises, leading to increased venous pressure and reduced venule diameter. At the most basic level, compartment syndrome is elevated pressure within a confined tissue space. Would like a cross-section of the leg indicating fascial compartments like this Ĭompartment syndrome may occur acutely or as a chronic syndrome. ACS is most commonly secondary to distal radius fractures in adults or supracondylar humerus fractures in children.Ĭross-section through middle of leg. The volar compartments contain the digital flexors and are at highest risk for compartment syndrome following trauma. The forearm also has four compartments at risk of compartment syndrome - deep and superficial volar, dorsal and lateral compartments. Signs of ACS affecting this compartment: pain and diminished sensation to lower leg in a superficial peroneal nerve distribution, the deep peroneal nerve may also be affected. It also contains the peroneal artery and the superficial peroneal nerve. The lateral compartment of the leg contains the peroneal muscles, longus and brevis. Signs of ACS affecting this compartment: pain and palpably tense compartment. The superficial posterior compartment of the leg contains the gastrocnemius, soleus and plantaris muscles. ![]() Signs of ACS affecting this compartment: plantar hypesthesia, weak to flexion, pain with passive stretch of toes and increasing pain. It also contains the posterior tibial artery and the tibial nerve. The deep posterior compartment of the leg contains tibialis posterior, flexor hallucis longus, flexor digitorum longus and poplitius. The most important symptom may be increasing pain, unrelieved by the usual analgesics and pain with passive flexion of the toes. Later foot drop, claw foot and deep peroneal nerve dysfunction may occur. Signs of acute compartment syndrome (ACS) affecting this compartment: loss of sensation between the first and second toes, weak foot dorsiflexion. It also contains the anterior tibial artery and the deep peroneal nerve. The anterior compartment of the leg contains tibialis anterior, extensor hallucis longus, extensor digitorum longus. The anterior and deep posterior compartments of the leg are the most common sites for compartment syndrome. Compartment syndrome is possible in any or all of the compartments. The leg and forearm both have four compartments encircled by inflexible facia. It most commonly occurs in the leg or forearm secondary to trauma and leads to decreased tissue perfusion below basal tissue requirements. Fasciotomy seems to be an effective method to help these patients return to their previous level of sports.Compartment syndrome is a limb-threatening condition caused by swelling within the myofacial compartments of the limb. Pain at the posterior thigh muscle compartment may sometimes become chronic and hamper the training of athletes. ![]() The patients were followed up for 19 months and the results of the fasciotomy were good or excellent in 39 cases. In four patients a simultaneous liberation, division or suturation of the muscle scar was done. Posterior fasciotomy (minimum 20 cm) to the thigh was performed through one or two incisions. Conservative treatment methods did not help to eliminate the symptoms during a long preoperative follow-up period. The symptoms were dull pain, stiffness, cramps and weakness of the posterior thigh during and after training. In the second group there was a history of hamstring muscle rupture or recurrent injuries. In the first group the symptoms appeared without any sudden trauma and most of the athletes competed in endurance sports (e.g. The patients could be divided, according to the etiology, in two groups: exertion (26 patients) and trauma (20 patients). Over a period of 13 years fasciotomy was performed on 46 athletes with chronic pain located at the posterior femoral muscle compartment. PDF Download Buy Article Permissions and Reprints
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