Anterior compartment syndrome: Difference between revisions

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{{Short description|A condition characterized by increased pressure within a muscle compartment of the body}}


{{Infobox medical condition (new)
'''Anterior compartment syndrome''' is a condition that occurs when there is increased pressure within the anterior compartment of the leg. This condition can lead to muscle and nerve damage and problems with blood flow.
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A [[compartment syndrome]] is an increased pressure within a muscular compartment<ref name="TravellSimons1992">{{cite book|author1=Janet G. Travell|author2=David G. Simons|title=Myofascial pain and dysfunction: the trigger point manual|url=https://books.google.com/books?id=MIQ9EXjZ5K0C&pg=PR361|accessdate=22 August 2010|date=1 October 1992|publisher=Lippincott Williams & Wilkins|isbn=978-0-683-08367-5|pages=361}}</ref> that compromises the circulation to the muscles.


==Symptoms==
==Pathophysiology==
Diffuse tightness and tenderness over the entire belly of the tibialis anterior muscle that does not respond to elevation or [[pain medication]] can be early warning signs and suggestive of Anterior Compartment Syndrome. Other common symptoms include excessive swelling that causes the [[skin]] to become hot, stretched and glossy.  Pain, [[paresthesia]]s, and tenderness in both the ischemic muscles and the region supplied by the deep [[common fibular nerve]] are exhibited by patients suffering from this condition. Sensitivity to passive stretch and active contraction are common, and tend to increase the symptoms.
The [[anterior compartment]] of the leg contains muscles, nerves, and blood vessels. It is bounded by the [[tibia]], [[fibula]], interosseous membrane, and a thick layer of fascia. When pressure within this compartment increases, it can compromise circulation and function of the tissues within the compartment. This is often due to bleeding or swelling after an injury.


==Pathology==
==Causes==
A compartment space is anatomically determined by an unyielding [[fascia]]l (and [[osseous]]) enclosure of the muscles.  The anterior compartment syndrome of the [[Human leg|lower leg]] (often referred to simply as anterior compartment syndrome), can affect any and all four muscles of that compartment: [[tibialis anterior]], [[extensor hallucis longus]], [[extensor digitorum longus]], and [[peroneus tertius]].
Anterior compartment syndrome can be caused by:
* [[Trauma]] to the leg, such as a fracture or severe contusion
* Overuse injuries, particularly in athletes
* Tight bandages or casts
* Burns
* Snake bites


This term is often mistakenly used to describe various related/proximal conditions, including Anterior [[Shin Splints]].  It is important to distinguish between the two, as shin splints rarely causes serious health problems, while Anterior Compartment Syndrome can lead to irreversible damage.
==Symptoms==
 
Symptoms of anterior compartment syndrome include:
The true compartment syndrome arises due to increased  pressure within the unyielding [[Fascial compartment|anterior compartment of the leg]].  The pressure obstructs venous outflow, which causes further swelling and increased pressure.  The resultant [[ischemia]] leads to [[necrosis]] (death of tissue) of the muscles and nerves.  The process can begin with swelling of the tibialis anterior, extensor hallucis longus, extensor digitorum longus, and/or the peroneus tertius muscles in response to strong [[eccentric contraction]]s sufficient to produce postexercise soreness.
* Severe pain in the leg, especially when stretching the muscles
* Swelling and tightness in the leg
* Numbness or tingling in the foot
* Weakness in the foot or toes


==Diagnosis==
==Diagnosis==
If these symptoms are observed/experienced it is important to contact a physician specializing in [[sports medicine]] ([[Doctor of Medicine|MD]]/[[Doctor of Osteopathic Medicine|DO]]), a [[Podiatrist|doctor of podiatric medicine]] (DPM), or other qualified health care professional immediately so as to get the appropriate advice/treatment before serious damage occurs.
Diagnosis is typically based on clinical examination and measurement of intracompartmental pressures. A pressure of more than 30 mmHg is often used as a threshold for diagnosis.


The 5 Ps of Anterior Compartment Syndrome:
#Pain
#Pallor
#Paresthesia
#Pulselessness
#Paralysis (If not treated)
==Treatment==
==Treatment==
The only option to treat acute compartment syndrome is surgery. The procedure, called a fasciotomy, involves a surgeon cutting open the skin and the fascia to relieve the pressure. Options to treat chronic compartment syndrome include physiotherapy, shoe inserts, and anti-inflammatory medications.
The primary treatment for anterior compartment syndrome is surgical intervention, known as [[fasciotomy]]. This procedure involves cutting open the fascia to relieve pressure. In some cases, conservative management may be attempted if the condition is mild.
 
==Prognosis==
If treated promptly, the prognosis for anterior compartment syndrome is generally good. However, if treatment is delayed, it can lead to permanent muscle and nerve damage.
 
==Prevention==
Preventive measures include:
* Proper training and conditioning for athletes
* Avoiding tight bandages or casts
* Monitoring for symptoms after leg injuries


==References==
==Related pages==
{{reflist}}
* [[Compartment syndrome]]
*ADAM Health Illustrated Encyclopedia Article, 8/3/2004
* [[Fasciotomy]]
== External links ==
* [[Muscle]]
{{Medical resources
* [[Nerve]]
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{{Myopathy}}


[[Category:Muscular disorders]]
[[Category:Medical conditions]]
[[Category:Syndromes]]
[[Category:Orthopedic surgery]]
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[[Category:Emergency medicine]]
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Revision as of 19:05, 22 March 2025

A condition characterized by increased pressure within a muscle compartment of the body


Anterior compartment syndrome is a condition that occurs when there is increased pressure within the anterior compartment of the leg. This condition can lead to muscle and nerve damage and problems with blood flow.

Pathophysiology

The anterior compartment of the leg contains muscles, nerves, and blood vessels. It is bounded by the tibia, fibula, interosseous membrane, and a thick layer of fascia. When pressure within this compartment increases, it can compromise circulation and function of the tissues within the compartment. This is often due to bleeding or swelling after an injury.

Causes

Anterior compartment syndrome can be caused by:

  • Trauma to the leg, such as a fracture or severe contusion
  • Overuse injuries, particularly in athletes
  • Tight bandages or casts
  • Burns
  • Snake bites

Symptoms

Symptoms of anterior compartment syndrome include:

  • Severe pain in the leg, especially when stretching the muscles
  • Swelling and tightness in the leg
  • Numbness or tingling in the foot
  • Weakness in the foot or toes

Diagnosis

Diagnosis is typically based on clinical examination and measurement of intracompartmental pressures. A pressure of more than 30 mmHg is often used as a threshold for diagnosis.

Treatment

The primary treatment for anterior compartment syndrome is surgical intervention, known as fasciotomy. This procedure involves cutting open the fascia to relieve pressure. In some cases, conservative management may be attempted if the condition is mild.

Prognosis

If treated promptly, the prognosis for anterior compartment syndrome is generally good. However, if treatment is delayed, it can lead to permanent muscle and nerve damage.

Prevention

Preventive measures include:

  • Proper training and conditioning for athletes
  • Avoiding tight bandages or casts
  • Monitoring for symptoms after leg injuries

Related pages

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