Anatomy
Anterior, lateral, superficial posterior and deep posterior
What are the compartments of the lower leg?
This medical condition occurs when increased pressure within a limited space compromises the circulation and function of the muscles and nerves within that space
What is compartment syndrome?
Cellulitis, deep vein thrombosis, necrotizing fascitis
What are DDx for compartment syndrome?
A surgical procedure where the fascia is cut to relieve tension or pressure commonly to treat the resulting loss of circulation to an area of tissue or muscle
What is fasciotomy?
Supplies the deep posterior compartment of the lower leg
What is the posterior tibial nerve?
Dorsiflexes the foot and ankle
What are the muscles of the anterior compartment?
Tissue perfusion is created by a gradient between these two types of pressure
What is arterial pressure (diastolic in particular) and venous capillary pressure
To obtain this measurement, use a manometer that will measure the resistance that is present when a saline solution is injected into the compartment
What is intracompartmental pressure?
Morphine is often given to manage pain in compartment syndrome. It produces the majority of its analgesic effects by binding to this, which eventually leads to an overall reduction of the nociceptive transmission.
What is the mu opioid receptor?
Supplies the superficial posterior compartment of the lower leg
What is the sural nerve?
Plantarflexes and everts the foot
What are the muscles of the lateral compartment?
When the tissue pressure within a compartment exceeds the venous capillary pressure, this can occur.
What is ischemia?
In this type of fracture, the bone snaps into two or more parts and moves so that the two ends are not lined up straight.
What is a displaced fracture?
This complication of compartment syndrome results from muscle injury, which may lead to acute kidney failure resulting from mechanical obstruction by myoglobin in the kidney.
What is rhabdomyolysis?
Supplies the lateral compartment
What is the superficial peroneal nerve?
Flexes the knee and ankle
What are the muscles of the superficial posterior compartment?
This type of tissue is relatively immune to ischemic damage
What is bone?
A displaced fracture where the bone is in many pieces
What is a comminuted fracture?
If fasciotomy is performed AFTER this much time, restoration of normal function is only expected in 8% of cases
What is 12 hours?
Supplies the anterior compartment of the lower leg
What is the deep peroneal nerve?
Plantarflexes the toes and performs inversion of the foot
What are the muscles of the deep posterior compartment?
After this much time in ischemic conditions, nerve tissues suffer irreversible damage
What is 8 hours?
These biomarkers indicating muscle cell damage can be used to identify rhabdomyolysis associated with acute compartment syndrome.
What are myoglobin and creatine phosphokinase?
A contraindication to fasciotomy that may render the procedure futile.
What is a missed timely diagnosis of compartment syndrome?
Terminal branches of the common peroneal nerve
What are the deep peroneal nerve and superficial peroneal nerve?