compartment syndrome
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Etiology
- blunt trauma, crush injury, motor vehicle accident
- burns
- chronic microtrauma
Pathology
- anterior compartment is most frequently involved
- compartmental pressures during weight-bearing exercise may be high enough to cause neurapraxia of the peroneal nerve
Clinical manifestations
- pain after exercise
- foot drop
- sensory loss
- peripheral pulses may or may not be palpable
- lower leg compartment syndrome:
- pain with passive stretching of foot or toes[6]
Diagnostic procedures
Radiology
* acute compartment syndrome requires urgent surgical evaluation
Complications
- edema & increased pressure from damage of trauma may result in myonecrosis & permanent dysfunction[6]
Differential diagnosis
Management
- acute compartment syndrome requires urgent surgical evaluation[6]
- surgery: limited fasciotomy (incision < 2 cm)
- chronic (not acute)
- rest
- adjustment of training
- patients generally return to full activity within 1 month
More general terms
More specific terms
- abdominal compartment syndrome
- chronic exertional compartment syndrome (CECS)
- orbital compartment syndrome
Additional terms
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 14, American College of Physicians, Philadelphia 1998, 2006
- ↑ Kosir R, Moore FA, Selby JH, Cocanour CS, Kozar RA, Gonzalez EA, Todd SR. Acute lower extremity compartment syndrome (ALECS) screening protocol in critically ill trauma patients. J Trauma. 2007 Aug;63(2):268-75. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17693823
- ↑ MedicineNet: Compartment Syndrome http://www.medicinenet.com/compartment_syndrome/article.htm
- ↑ 4.0 4.1 Egan AF, Cahill KC Compartment Syndrome. N Engl J Med 2017; 377:1877. November 9, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29117495 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMicm1701729
- ↑ 5.0 5.1 5.2 de Bruijn JA et al. Chronic exertional compartment syndrome in the differential diagnosis of peripheral artery disease in older patients with exercise-induced lower limb pain. J Vasc Surg 2021 Jun; 73:2114. https://www.jvascsurg.org/article/S0741-5214(20)32498-8/fulltext
- ↑ 6.0 6.1 6.2 6.3 NEJM Knowledge+ Rheumatology
- ↑ 7.0 7.1 Barnes DK, Randhawa SDS, Fitzpatrick EP. Under Pressure: Delayed Diagnosis of Compartment Syndrome after Lower Leg Fracture. PSNet. April 24, 2024 https://psnet.ahrq.gov/web-mm/under-pressure-delayed-diagnosis-compartment-syndrome-after-lower-leg-fracture