Compartment Syndrome of the Foot
Original Editors - Jessie Tourwe
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Search Strategy [edit | edit source]
Databases searched: Pubmed, PEDro, eMedicine, Medscape
Keywords searched: compartment syndrome foot, lower leg, loge syndrome, crush injuries, treatment compartment syndrome,…
Definition/Description[edit | edit source]
This syndrome is a condition that can appear in many parts of the body: foot, leg, thigh, forearm, hand, buttocks etc.[1] A compartment syndrome occurs when the muscles along with nerves and blood vessels are compressed in a compartment.
The developing of swelling and/or a hematoma causes the pressure to increase and because the fascia – made of inelastic connective tissue – can’t extend, the blood flow is disrupted. Tissue death can take place if the concentration of oxygen drops too low for too long.[2]
Clinically Relevant Anatomy[edit | edit source]
Anatomical studies of muscles and tendons show that the foot is divided into 4 large compartments (interosseous, medial, lateral, central) each including muscles, nerves and arteries. Early researches identified 9 compartments. However, it is very impractical to divide the foot into more than four compartments. That’s why most of the recent studies still refer to the foot as a whole of four compartments.[3]
-Interosseous compartment: Dorsal interossei muscles Plantar interossei muscles Plantar lateral artery, vein and nerve
|
- Medial compartment: Abductor hallucis Flexor hallucis brevis Tendon of flexor hallucis longus Medial plantar arteries, veins and nerves
|
- Lateral compartment: Abductor digiti minimi Flexor digiti minimi Opponens digiti minimi Branches of the lateral plantar artery vein and nerve
|
- Central compartment (3 levels): |
Epidemiology /Etiology [edit | edit source]
Characteristics/Clinical Presentation[edit | edit source]
The most specific signs are:
- The skin appears pale and tensely swollen on the spot of tissue damage.
- Pain occurs when squeezing and/or touching the affected compartments.
- Pain when applying passive stretching to ankle, metatarsal joints and toes.
- Increased pain on dorsal flexion of the metatarsophalangeal joints.
- Muscle weakness of the intrinsic foot muscles when moving the foot in any way.
- Enlarged soreness radiating to the toes when moving them actively up and down.
Late findings are:
- It is possible the pulses are not palpable because the foot is very swollen.
- Neurological deficits: when a nerve is damaged the patient can report a decreased sensation.[3]
Considering the 5 P’s: Pain, Pallor, Paresthesia, Paralysis, Pulselessness[1]
Differential Diagnosis[edit | edit source]
Diagnostic Procedures[edit | edit source]
Outcome Measures[edit | edit source]
add links to outcome measures here (also see Outcome Measures Database)
Examination[edit | edit source]
add text here related to physical examination and assessment
Medical Management
[edit | edit source]
add text here
Physical Therapy Management
[edit | edit source]
Key Research[edit | edit source]
add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
add appropriate resources here
Clinical Bottom Line[edit | edit source]
add text here
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
Extension:RSS -- Error: Not a valid URL: Feed goes here!!|charset=UTF-8|short|max=10
References[edit | edit source]
see adding references tutorial.
- ↑ 1.0 1.1 Abraham T Rasul Jr. Compartment syndrome. eMedicine. 11 March 2009 http://emedicine.medscape.com/article/307668-overview (accessed on november/december 2010)
- ↑ Frink M, Hildebrand F, Krettek C, Brand J, Hankemeier S. Compartment syndrome of the lower leg and foot. The Association of bone and joint surgeons. 27 may 2009 http://emedicine.medscape.com/article/140002-overview (accessed november/december 2010)
- ↑ 3.0 3.1 Haddad S L, Managing risk: compartment syndromes of the foot. American Academy of Orthopaedics Surgeons, Jan/Feb 2007 http://www.aaos.org/news/bulletin/janfeb07/clinical1.asp (accessed on november/december 2010)
- ↑ Schünke M, Schulte E, Schumacher U, Voll M, Wesker K. Prometheus. Bohn Stafleu Van Loghum, Houten 2005. Pg 463