Compartment Syndrome of the Lower Leg

Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Geoffrey De Vos

Lead Editors - Your name will be added here if you are a lead editor on this page.  Read more.

Search Strategy

I searched the PEDro –database, The Physiotherapy Evidence Database and Pubmed (medline)database to gain some information. In this databases I mostly searched for information (articles, EBP) that can be useful for physiotherapists, so subjects like diagnosis and treatment were my aim. I also searched information in books (literature) (see resources). I often used keywords as: compartment syndrome of lower leg・chronic exertional compartment syndrome ・Rehabilitation ・diagnosis ・treatment

Definition/Description

Compartment syndrome, in this case compartment syndrome of lower leg, is the compression of nerves, blood vessels, and muscle(s) inside a closed space (compartment) within the body ( see clinically relevant anatomy for more information about these compartments). This injury may lead to tissue death (necrosis) due to the blood vessels being compressed by the raised pressure within the compartment. So this compression causes an ischemia, a lack of oxygen, that can result in serious and dangerous tissue damages or tissue death when this injury isn’t treated well. Compartment syndrome most often involves the forearm and lower leg, and can be divided into acute, subacute, and chronic compartment syndrome ¹. This syndrome occurs fairly regularly and occurs in most of the times in athletes, such as long distance runners, soccer players and basketball players. It can also occur in children, adolescents or adults, but more often in adults^2&3.

Clinically Relevant Anatomy

The lower leg has four compartments. These four compartments are bordered by the tibia, fibula, interosseous membrane and the surrounding fasciae. The anterior compartment contains the profound peroneal nerve, tibial anterior muscle, extensor hallucis longus and extensor digitorum muscle. In the lateral compartment are the nervus peroneus communis and superficial peroneal nerve, the peroneus longus and brevis muscle. In the deep posterior compartment are the arteria, vena and nervus tibialis, the posterior tibial muscle, musculus flexor hallucis longus and flexor digitorum longus. The superficial posterior compartment consists of the sural nerve, the gastrocnemius muscle and the soleus muscle.¹
All this compartments are surrounded by fascia. This fascia is connected to bone and each of them has a blood and nerve supply. These fascias do not expand and when a compartment swells the pressure inside the compartment will increase which will cause tissue necrosis due by the compressing of blood vessels (decreased or no oxygen supply) and nerves.

Epidemiology /Etiology

add text here

Characteristics/Clinical Presentation

add text here

Differential Diagnosis

add text here

Diagnostic Procedures

add text here related to medical diagnostic procedures

Outcome Measures

add links to outcome measures here (also see Outcome Measures Database)

Examination

add text here related to physical examination and assessment

Medical Management

add text here

Physical Therapy Management

add text here

Key Research

add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)

Resources

add appropriate resources here

Clinical Bottom Line

add text here

Recent Related Research (from Pubmed)

see tutorial on Adding PubMed Feed

References

see adding references tutorial.