![]() (That this compartment does not containĪn artery is of particular interest to those who write student examinationĬompartment contains the gastrocnemius, soleus and plantaris muscles, along Notably, the peronealĪrtery lies in the posterior compartment and supplies the lateral compartment through anastomoticīranches that course around the fibula. The vascular supply is through the peroneal artery. The peroneus longus and peroneus brevis muscles and the superficial peroneal Web space of their foot, which is innervated by the deep peroneal nerve.Īnterior compartment can result in “foot drop,” a condition where patients cannot Pressure, patients may complain of a “pins and needles” sensation in the first Also in thisĬompartment are the deep peroneal nerve and the anterior tibial artery and vein. The anterior compartment contains the muscles that primarily dorsiflex (extend) the ankle and the toes: the tibialisĪnterior, extensor hallucis longus, and extensor digitorum longus. The space surrounded byĪ given fascial covering is known as a compartment.Ĭommonly involved in compartment syndrome, has four anatomical compartments: theĪnterior, lateral, deep posterior, and superficial posterior compartments (Figuresįigure 2: The four compartments of the leg and their contents are shown in situ. Definitive treatment is surgical with urgentįasciotomy: cutting the fascia that surrounds the compartment, therebyīy a band of strong connective tissue known as fascia. Diagnosis can be confirmed with measurement of the pressure inside theĬompartment, but diagnosis can be made on clinical grounds alone in high-risk Increasing pain as lactate – the product of anaerobic metabolism – builds up). The diagnosis can be made on the basic clinical signs and symptoms (especially Avoiding complicationsįrom compartment syndrome requires timely diagnosis and expeditious treatment. Tight casts, or by infiltration of an intravenous line. Compartment syndrome can also be caused by Surgery (a so-called reperfusion injury). The muscles and nerves in the space or passing through it.Ĭaused by trauma, such as a tibia fracture, but can be seen after vascular In turn, the lack of perfusion leads to hypoxia and damage to Nearly half of all service members undergoing fasciotomy reported persistent symptoms, and one in five individuals had unsuccessful surgical treatment.The state of increased pressure in a closed tissue space that impairs bloodįlow to that space. Multivariable analysis confirmed significant associations between surgical failure and perioperative complications (OR, 1.72), activity limitations (OR, 2.23), and persistence of preoperative symptoms (OR, 5.47), whereas other factors were not significantly associated with surgical failure.Ĭhronic exertional compartment syndrome is a substantial contributor to lower-extremity disability in the military population. Univariate analysis of prognostic factors revealed that surgical failure was associated with bilateral involvement (odds ratio, 1.64), perioperative complications (OR, 2.12), activity limitations (OR, 4.41), and persistence of preoperative symptoms (OR, 8.46). Surgical complications were documented for 15.7% of the patients, 5.9% underwent surgical revision, and 17.3% were referred for medical discharge because of chronic exertional compartment syndrome. Symptom recurrence was reported by 44.7% of the patients, and 27.7% were unable to return to full activity. Of the surgical procedures, 77.4% involved only anterior and lateral compartment releases 19.4% addressed the anterior, lateral, and posterior compartments and 2.2% addressed the posterior compartments alone. The average patient age was 28.0 years, and 91.8% of the patients were male. Army Physical Disability Agency database.Ī total of 611 patients underwent 754 surgical procedures. Demographic variables including age, sex, and rank were extracted, and rates of postoperative complications, activity limitations, and revision surgery or medical discharge were obtained from the electronic medical record and U.S. Individuals who had undergone surgical fasciotomy of the anterior, lateral, and/or posterior compartments (current procedural terminology codes 27600, 27601, and 27602) for nontraumatic compartment syndrome of the lower extremity (International Classification of Diseases, Ninth Revision code 729.72) between 20 were identified from the Military Health System Management Analysis and Reporting Tool (M2). We are not aware of any previous study in which the authors rigorously evaluated the rates of return to full activity, persistent disability, and surgical revision after operative management of chronic exertional compartment syndrome of the leg in a large, physically active population. Chronic exertional compartment syndrome of the leg is a frequent source of lower-extremity pain in military personnel, competitive athletes, and runners.
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