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Results for “Anterior Compartment Syndrome”

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At least 19 recordsLinked to original sources
PubMed1983

Results of fasciotomy in patients with medial tibial syndrome or chronic anterior-compartment syndrome.

I studied the results of fasciotomy of the affected muscle compartment in eight patients with chronic anterior-compartment syndrome (involvement of the anterior tibial compartment) and in nine patients with medial tibial syndrome (involvement of the deep posterior compartment), all of whom had pain with exercise. In the patients with chronic anterior-compartment syndrome, the preoperative intramuscular pressure in the anterior tibial compartment, as measured by the wick-catheter method, was increased ten minutes after exercise to 52 +/- 36 millimeters of mercury. After fasciotomy this pressure was significantly lowered to 4 +/- 6 millimeters of mercury (p less than 0.01). In the patients with medial tibial syndrome, the preoperative intramuscular pressure in the deep posterior compartment was normal ten minutes after exercise (8 +/- 4 millimeters of mercury) and did not significantly change after the fasciotomy (5 +/- 6 millimeters of mercury). The clinical results after fasciotomy were good in both groups of patients. There was complete relief of pain in all of the patients with chronic anterior-compartment syndrome and in five of the nine patients with medial tibial syndrome. The other four patients considered their condition to be improved in spite of some remaining symptoms.

Adolescent↗
PubMedDate not supplied

Fasciotomy for exertional anterior compartment syndrome: is lateral compartment release necessary?

The standard surgery for exertional anterior compartment syndrome is fasciotomy of the anterior and lateral compartments of the leg. We prospectively studied the necessity of lateral compartment release, which can add morbidity and extend recovery. We performed 30 anterior compartment releases in 20 patients (10 bilateral operations) with exertional anterior compartment syndrome but not lateral compartment involvement. We alternately performed only an anterior compartment release or both anterior and lateral compartment releases on 10 patients. The 10 patients who underwent bilateral surgery each had, during the same surgery, an anterior and lateral compartment release on one leg and only an anterior compartment release on the other. All were athletes involved in running sports. Overall, satisfactory outcomes were seen in 90% of the limbs--93% (14 of 15) that had anterior compartment release and 87% (13 of 15) that had release of both compartments (no statistically significant difference). For the patients who had unilateral surgery, the average time for full return to sports was 8.1 weeks after anterior release only and 11.4 weeks after release of both compartments, a statistically significant difference. The average time for full return to sports after bilateral surgery was 12.1 weeks. Among these patients, seven said that the leg with only anterior release seemed to recover faster. We concluded that when doing a fasciotomy for exertional anterior compartment syndrome alone, a lateral compartment release is not necessary.

Adolescent↗
PubMedDate not supplied

Anterior compartment syndrome: a case report.

The chronic form of the anterior compartment syndrome can be overlooked if the symptoms of leg pain are attributed to shin splints. Herein is presented a case report which I feel represents an acute exacerbation of the chronic form of anterior compartment syndrome in a long-distance runner secondary to bleeding into the extensor digitorum longus muscle. Chronic anterior compartment syndrome can be a disabling injury which may require a fasciotomy, depending upon the severity and duration of the patient's symptoms and the intracompartmental pressures. The lay term "shin splints" should be separated from medical use, and a more reliable assessment of the etiology of the patient's symptoms should be made. The term shin splints should be utilized only for pain localized to the posterior medial border of the tibia at the origin of the posterior tibialis muscle.

Adult↗
PubMed1992

Anterior compartment syndrome of the thigh in athletes--indications for conservative treatment.

Anterior compartment syndrome of the thigh resulting from blunt contusion without an accompanying fracture is rare. The treatment advocated for it by most authors has been surgical. However, because wound infection rates are high and loss of knee range of motion is frequent, we considered conservative treatment in selected patients. Six athletes who developed an anterior thigh compartment syndrome shortly after sustaining a blunt contusion to the quadriceps with an accompanying massive hematoma were studied prospectively. Tissue pressure, renal function, and creatinine phosphokinase (CPK) levels were closely monitored. Fasciotomy was not performed, despite sustained pressure elevations above 50 mm Hg. Neurologic function was not affected. At follow-up examination 1 year later, no limitation of joint motion nor weakness of the quadriceps were observed. Thus in selected young patients in whom an isolated anterior compartment syndrome of the thigh occurs, conservative treatment yielded results superior to fasciotomy.

Adult↗
PubMed1996

Anterior compartment syndrome after revision hip arthroplasty.

We report a case of anterior compartment syndrome in the ipsilateral leg after a revision total hip arthroplasty. Possible causes include post-ischaemic swelling after occlusion of the vessels during prolonged surgery and vigorous repetitive stretching of the muscles of the anterior compartment from the intraoperative use of electrical calf stimulators. Epidural infusions for postoperative analgesia may mask symptoms, but when there is clinical suspicion, we recommend measurement of the compartment pressures and early fasciotomy.

Acute Disease↗
PubMed2004

[Chronic exertional anterior compartment syndrome of the leg with fascial hernia--case report and review of the literature].

18-year-old female with chronic exertional anterior compartment syndrome was described. Pain was localized on the anterior part of the leg after long distance walking or another physical activity. Disorder was confirmed by electromyography and using Compartmental Pressure Monitor System (Stryker, USA). Intracompartmental pressure was measured three times--after rest, immediately after exercises and again after 30 min. rest. During measurement each compartment was injected by 0.2 ml 0.9% NaCl. The pressure value was noted 10 seconds later. The following values were noted: resting pressure--9 mmHg (normal 0-5 mm), immediately after exercises (active dorsal flexion of the foot)--99 mmHg (normal < 30 mm), after 30 minutes rest--29 mmHg. The patient was treated operatively by subcutaneous fasciotomy of the anterior and lateral compartment of the leg. This procedure was combined with neurolysis of the neural branches within a hernia. 6 months later at follow-up examination complete disappearing of the pain was confirmed. Chronic exertional anterior compartment syndrome should be consider in diagnostics of the lower extremity pain unknown origin in young adults (sportsmen).

Adolescent↗
PubMed2005

Revision surgery for exertional anterior compartment syndrome of the lower leg: technique, findings, and results.

BACKGROUND: Recurrent symptoms or failure after fasciotomy for exertional anterior compartment syndrome is not uncommon. HYPOTHESIS: Symptoms from high compartment pressures can be secondary to involvement of the entire compartment or to localized constrictions from postsurgical fibrosis, as well as to entrapment of the superficial peroneal nerve. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Eighteen patients who underwent revision surgery for exertional anterior compartment syndrome were available for follow-up. All were athletes who had either a failure or a recurrence of symptoms at a mean of 23.5 months (range, 8-54 months) after the index fasciotomy. Pressure measurements using a slit catheter at rest, at 1 minute postexercise, and at 5 minutes postexercise were performed in 2 places within the compartment: in the area of the previous incision and in the proximal muscle belly of the tibialis anterior. Surgical technique consisted of a 2-incision approach with partial fasciectomy, exploration and decompression of the superficial peroneal nerve, and excision of all fibrotic tissue. An objective examination and a comprehensive subjective questionnaire previously described were performed at a mean follow-up of 42 months (range, 22-67 months). RESULTS: Sixty percent of patients had abnormal pressures only in a localized area, whereas 40% had high pressures throughout the compartment. Eight of 18 (44%) patients had symptoms, signs, and surgical findings of entrapment of the superficial peroneal nerve. At follow-up, 72% of patients had a satisfactory outcome (5 excellent, 8 good), and 28% had an unsatisfactory outcome for intense running sports (4 fair, 1 poor), although 3 patients with the fair results reported improvement with low-level activity. All 8 patients with documented peroneal nerve entrapment had a satisfactory outcome. CONCLUSION: Symptoms from high pressures can be secondary to involvement of the entire compartment or localized to a certain area from postsurgical fibrosis. Pressure measurements should be performed in at least 2 separate areas.

Compartment Syndromes↗
PubMed1995

Acute exertional anterior compartment syndrome in an adolescent female.

Acute compartment syndromes usually occur as a complication of major trauma. While the chronic exertional anterior tibial compartment syndrome is well described in the sports medicine literature, reports of acute tibial compartment syndromes due to physical exertion, or repetitive microtrauma, are rare. The case of an adolescent female who developed an acute anterior compartment syndrome from running in a soccer game is described in this report. Failure to recognize the onset of an acute exertional compartment syndrome may lead to treatment delay and serious complications. Whereas the chronic exertional anterior compartment syndrome is characterized by pain that diminishes with the cessation of exercise, the onset of the acute exertional anterior compartment syndrome is heralded by pain that continues, or increases, after exercise has stopped. Compartment pressure measurement confirms the clinical diagnosis and helps guide treatment. True compartment syndromes require urgent fasciotomy.

Acute Disease↗
PubMed1986

Chronic anterior-compartment syndrome of the leg. Results of treatment by fasciotomy.

Thirty legs in nineteen patients, eleven with bilateral and eight with unilateral chronic anterior-compartment syndrome, were treated by fasciotomy. In addition, five of these patients (six legs) had compression of the superficial peroneal nerve: two before and three after fasciotomy. One patient also had lateral compartment syndrome in one leg. The patients who had compression of the superficial peroneal nerve were relieved by partial fasciectomy and fasciotomy of the lateral compartment. In one of these patients, with bilateral nerve compression, both superficial peroneal nerves were anomalous. The patient who had lateral compartment syndrome was relieved by fasciotomy of this compartment. Two patients required a second fasciotomy due to recurrence of the chronic compartment syndrome. At an average length of follow-up of twenty-five months after fasciotomy for anterior compartment syndrome, functional capacity was unlimited or increased in eighteen patients (twenty-eight legs) and was unchanged in one patient (two legs) who had had compression of the superficial peroneal nerve. The intramuscular pressures in the anterior compartment were normal at rest as well as during and after exercise eight months after the original fasciotomy in twenty-eight legs and eight months after the second fasciotomy in two legs.

Adolescent↗
PubMedDate not supplied

The anterior compartment syndrome in the lower leg. Review and role of the EMG examination.

The Anterior Compartment Syndrome is a relatively rare affection with a wide spectrum of etiologies. Like every compartment syndrome, it is a condition in which high pressure in a rigid osteofascial space reduces capillary blood perfusion so that tissue viability is threatened. When pressure remains sufficiently high for a number of hours, normal muscle and nerve functions become disturbed which may lead to myoneural necrosis. Therefore, an early decompression by means of fasciotomy is essential. Clinical examination is of critical importance in reaching a diagnosis: first of all a painful swelling occurs, followed by muscular paresis or paralysis, and finally loss of sensation and a "silent" electromyogram (EMG). In some cases pressure measurements are necessary, in which tissue pressures over 30 to 40 mm Hg are considered abnormal. The EMG-examination is useful in order to achieve a diagnosis and to assess the degree of injury. It may be an important guide for further rehabilitation.

Aged↗
PubMed1987

Diagnosis of chronic anterior compartment syndrome in the lower leg.

Intramuscular pressure was recorded in 80 patients suspected of suffering from chronic anterior compartment syndrome in the lower leg; the diagnosis was verified in 22 of these patients. The history and clinical findings of the chronic compartment syndrome patients were compared with those of the 58 patients without the syndrome. Pain induced only by athletic activity and only in the anterior lower leg forcing the patient to interrupt running indicated chronic compartment syndrome. The history and clinical findings alone were found to be insufficient to establish the diagnosis. In relation to generally accepted pressure parameters at rest, the muscle relaxation pressure during exercise was found to be a reliable parameter for diagnosing chronic compartment syndrome, whereas mean muscle pressure and muscle contraction pressure were found to be unreliable.

Adolescent↗
PubMed1994

Spontaneous non-traumatic anterior compartment syndrome with peroneal neuropathy and favorable outcome.

We report a girl who spontaneously developed an anterior compartment syndrome with an associated deep peroneal neuropathy. Initial nerve conduction studies (NCS) recorded from the extensor digitorum brevis muscle demonstrated prolongation of the distal latency to 7.8 msec (normal contralateral side, 3.6 msec), and reduction in amplitude of the compound muscle action potential to 0.1 mV (normal contralateral side, 9.9 mV). Electromyography of the tibialis anterior muscle showed an absence of motor unit potentials. Serum creatine kinase was markedly elevated to 12,769 IU. Computed tomography (CT) showed evidence of necrotic muscle. One month later, the foot drop, repeat NCS, and CT demonstrated a significant improvement with conservative management.

Anterior Compartment Syndrome↗
PubMed1995

Anterior dissection of popliteal cyst causing anterior compartment syndrome.

Dissection and rupture of popliteal cysts occur commonly. We describe a case of a 13-year-old girl with polyarticular juvenile rheumatoid arthritis who presented with anterior tibial swelling and dropped foot. She was found to have dissecting popliteal cyst resulting in anterior compartment syndrome.

Adolescent↗
PubMed1985

Anterior compartment syndrome in a patient with fracture of the tibial plateau treated by continuous passive motion and anticoagulants. Report of a case.

Open reduction and internal fixation with anterior compartment fasciotomy for fractures of both tibial plateaus in a 36-year-old woman was complicated by deep-vein thrombosis three days after surgery. After establishing anticoagulation, continuous passive motion (CPM) was instituted. Twenty-four hours after the commencement of CPM, an anterior compartment syndrome developed. A second operation revealed a large hematoma within the anterior compartment musculature, the development of which appeared to be the result of the combination of continuous passive motion and anticoagulation therapy in a seriously injured limb. In this clinical condition, especially close observation for the development of signs of elevated intracompartmental pressure is mandatory.

Adult↗
PubMed2001

Chronic anterior compartment syndrome and deep peroneal nerve function.

OBJECTIVE: We hypothesized that athletes with chronic anterior exertional compartment syndrome (CAECS) would demonstrate an impairment in deep peroneal nerve function, as determined by electrodiagnostic studies or neuromuscular examination, either at baseline as compared with control athletes or after exercise. DESIGN: Prospective, controlled study comparing athletes with CAECS to asymptomatic athletes. SETTING: Outpatient, academic practice. PARTICIPANTS: Ten athletes with CAECS were recruited sequentially over 1 year from an outpatient academic practice; diagnosis was confirmed by history, physical examination, and compartment pressure testing. Ten similarly aged control athletes were recruited from the surrounding facility. INTERVENTION: Repetitive dorsiflexion exercise to the point of typical symptoms (CAECS subjects) or fatigue (control subjects). MAIN OUTCOME MEASURES: Deep peroneal nerve conduction study velocity and amplitude; neuromuscular examination in the deep and superficial peroneal distributions. RESULTS: Control subjects demonstrated a significant increase in peroneal motor amplitudes postexercise as compared with preexercise (6.3 +/- 2.2 mV preexercise to 8.2 +/- 3.1 mV postexercise; p = 0.033), but the CAECS subjects did not (8.8 +/- 2.6 to 8.9 +/- 2.1; p = 0.89). At baseline and postexercise, the subjects with CAECS demonstrated decreased vibratory sensation compared with the controls (p = 0.030 at baseline and 0.045 postexercise). CONCLUSIONS: Athletes with CAECS demonstrate a decreased postexercise potentiation of the peroneal motor amplitude and a mild impairment in vibratory sensation; these findings may contribute to their sense of poor foot and ankle control. Further study is necessary before the absence of postexercise potentiation of the peroneal motor amplitude may be considered a diagnostic sign of CAECS.

Adolescent↗
PubMed1995

The effects of elevated compartment pressure on tibial arteriovenous flow and relationship of mechanical and biochemical characteristics of fascia to genesis of chronic anterior compartment syndrome.

PURPOSE: The purpose of this study is to evaluate the effects of increased compartment pressure on anterior tibial arteriovenous flow patterns and to determine whether mechanical and biochemical properties of fascia are responsible for compartment pressure abnormalities. METHODS: Twenty patients with chronic anterior compartment syndrome (CACS) and 20 age-matched control subjects had compartment pressure measurements and analysis of tibial arterial and venous flow before and after fasciectomy. Fascia specimens were evaluated for thickness, stress failure, structural stiffness, and total collagen content and prevalence of collagen cross-linkage. RESULTS: Pressures were significantly elevated in patients with CACS versus control subjects (23.8 mm Hg vs 6 mm Hg). No significant difference in tibial arterial flow could be detected in either group (43 cm/sec mean vs 41.9 cm/sec mean). Venous drainage was severely impaired in patients with CACS but not in control subjects. CACS fascia was thicker and stiffer than control fascia specimens (0.35 mm +/- 0.12 mm, 109 +/- 65 MN/mm; versus 0.22 mm +/- 0.06 mm; 60.3 +/- 22 MN/mm). Fasciectomy normalized postoperative compartment pressures and improved venous drainage. Collagen content per unit mass was similar for both CACS and control fascia specimens, although collagen cross-linking was significantly lower in the CACS fascia than in the controls. CONCLUSIONS: Tibial venous drainage is impaired, but arterial flow is not in patients with CACS. Fascia thickness and structural stiffness can account for increased pressure in CACS compartments. Collagen content and cross-linkage are unrelated to fascia stiffness or thickness. Postoperative improvement in vascular hemodynamics and reduction in compartment pressure is caused by increased capacitance in the compartment after fasciectomy.

Anterior Compartment Syndrome↗