Frink M, Hildebrand F, Krettek C, Brand J, Hankemeier S, et al.
Clinical orthopaedics and related research. Date of publication 2010 Apr 1;volume 468(4):940-50.
1. Clin Orthop Relat Res. 2010 Apr;468(4):940-50. doi: 10.1007/s11999-009-0891-x.
Epub 2009 May 27.
Compartment syndrome of the lower leg and foot.
Frink M(1), Hildebrand F, Krettek C, Brand J, Hankemeier S.
Author information:
(1)Department of Traumatology, Hannover Medical School, Hannover, Germany.
Frink.Michael@mh-hannover.de
Compartment syndrome of the lower leg or foot, a severe complication with a low
incidence, is mostly caused by high-energy deceleration trauma. The diagnosis is
based on clinical examination and intracompartmental pressure measurement. The
most sensitive clinical symptom of compartment syndrome is severe pain. Clinical
findings must be documented carefully. A fasciotomy should be performed when the
difference between compartment pressure and diastolic blood pressure is less
than 30 mm Hg or when clinical symptoms are obvious. Once the diagnosis is made,
immediate fasciotomy of all compartments is required. Fasciotomy of the lower
leg can be performed either by one lateral incision or by medial and lateral
incisions. The compartment syndrome of the foot requires thorough examination of
all compartments with special focus on the calcaneal compartment. Depending on
the injury, clinical examination, and compartment pressure, fasciotomy is
recommended via a dorsal and/or medial plantar approach. Surgical management
does not eliminate the risk of developing nerve and muscle dysfunction. When
left untreated, poor outcomes with contractures, toe deformities, paralysis, and
sensory neuropathy can be expected. In severe cases, amputation may be
necessary.
LEVEL OF EVIDENCE: Level III. See Guidelines for Authors for a complete
description of levels of evidence.
DOI: 10.1007/s11999-009-0891-x
PMCID: PMC2835588
PMID: 19472025 [Indexed for MEDLINE]
