where a needle is placed into the area, the only valuable test to diagnose this syndrome, otherwise known as intracompartmental pressure monitoring.įoot and Ankle visual analog scale from the American Orthopaedic Foot and Ankle Society measures the quality of life after fasciotomy. Ī quick and safe procedure to diagnose compartment syndrome is invasive measurement. Where compartment syndrome is suspected, frequent examination is required in the acute phase, sometimes hourly, as muscle necrosis can occur within 3 hours. Diagnostic Procedures Īwareness of the signs and symptoms specific to this syndrome are key to an accurate diagnosis, alongside an appropriate clinical examination. Other consequences consist of a reduced supply of blood and fluid supply to tissues. The 5 P’s may be considered when diagnosing compartment syndrome: Pain, Pallor, Paresthesia, Paralysis, Pulselessness Differential Diagnosis Ĭompartment syndrome is characterised by an increase of the interstitial pressure with severe pain and pain associated with passive stretching of the muscles as a result. Muscle weakness of the intrinsic foot muscles.Firmness of the involved compartments.Sensory deficits caused by neurological injury.Pain on palpation or compressing the affected compartments.Increased soreness caused by moving the toes.Pain during active dorsiflexion of the ankle.Typically, the pain is described as an aching and/or burning sensation. Pain is one of the key symptoms for compartment syndrome, being severe and spontaneous or occurring during active exercises, often increasing in intensity as the activity continues, only resolving on rest. Ĭrush injuries are the most common cause of compartment syndromes of the foot, as well as snake bites, burns, too tightly fitted bandages or casts, metatarsal fractures, talus or calcaneus fractures, Chopart and/or Lisfranc joint dislocations, steroid or creatine use which can cause muscles to increase in volume. Other causes can be biomechanical abnormailities, limb length differences, muscle weakness or muscular tightness. Training programmes may be inappropriate or incorrect footwear could be a cause. Sports like football, motorcross, running, tennis and gymnastics can be risk factors. The muscles become fatigued and irritated resulting in an inflammatory response and swelling. Ĭhronic (exertional) compartment syndrome can develop through over exertion during sporting activity. The calcaneal compartment seems to be at higher risk for developing compartment syndrome, whereas the interosseous compartments are usually at a lower risk. Incidence of compartment syndrome of the foot is low. All levels of the central compartment contain (deep) branches of the plantar lateral artery, vein and nerveĮpidemiology /Etiology.Second level: Quadratus plantae lumbrical muscles tendons of flexor digitorum longus.
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