Unrecognized Anterior Compartment Syndrome Following Ankle Fracture Surgery (original) (raw)

Acute compartment syndrome of the foot in a soccer player: a case report

The Journal of the Canadian Chiropractic Association, 2011

To present the diagnostic and clinical features including management of acute compartment syndrome (ACS) of the foot and to create a sense of emergency amongst clinicians of this rare and dangerous condition. A 28-year old male soccer player on acetylsalicylic acid (ASA) and verapamil presented with severe swelling, paresthesia, and pain in the left ankle after an acute grade three-inversion ankle sprain. A diagnosis of foot compartment syndrome was made. A fasciotomy was not performed and subsequent neurological sequelae occurred. We hypothesize that the edema caused by the ankle sprain was excessive due to the use of ASA and verapamil, resulting in increased compartmental pressure and neurological signs in the foot. Although rare, it is extremely important to be aware of the clinical features of ACS of the foot to obtain an appropriate diagnosis and manage this medical emergency promptly.

Unusual Presentation of Foot Compartment Syndrome

International Journal of Case Reports in Medicine, 2013

Introduction: This article presents a case of acute compartment syndrome of the foot following open reduction and internal fixation of an ankle fracture. After have a tree fall onto his ankle, a 34 year old fit and well Caucasian male tree surgeon was admitted with a left lateral malleolus and distal tibia fracture. The original plan was to internally fix the large medial fragment with a condylar plate and similarly internally fix the lateral side with a fibular plate. An 8 holes plate was fitted on the lateral side and (due to the presence of fracture blisters) 2 x6.5mm cannulated screws on the medial side were used. It was then noted on day 1 post operation that the pain was not controlled despite using the PCA and oral analgesics. The patient also started to complain of paraesthesia and numbness over the plantar aspect of the operated ankle. Case Presentation: The patient had good capillary refill but had intense pain on passive stretch and firm compartments were present. A fasciotomy was performed via 2 dorsal incisions over the 1st and 4th web spaces which resulted in immediate postoperative pain relief. Conclusion: Acute traumatic compartment syndrome of the foot is a serious potential complication after fractures, crush injuries, or reperfusion injury post vascular repair. Foot compartment syndrome in association with injury to the ankle is rare, with only 4 case reports found in the literature.

Exertional Compartment Syndrome in Five Collegiate Athletes

Orthopedic research online journal, 2019

Five collegiate athletes (age=19.5+1.5) suffered symptoms of exertional compartment syndrome (ECS) within the same calendar year. Two athletes suffered from unilateral ECS (anterior & lateral), two athletes suffered from bilateral ECS (1 anterior & lateral, 1 all four compartments), and one athlete suffered bilateral ECS (1 posterior, 1 anterior & lateral) on two separate occasions during the year. The sports medicine staff evaluated all five athletes in the athletic training room upon complaints of lower leg pain. Athletes were referred to sports medicine physician to discuss a plan of action or obtain both resting and exercising compartmental pressures. Surgical fasciotomies were performed in three cases to release compartment pressure. ECS cases can be attributed to any one of the following issues: running surface, footwear, abnormal gait, acute direct trauma, or chronic repetitive activities. All cases in our study participated in different sports, practiced or competed on different surfaces, and were not at the same time period of the competitive year. The only common theme was that all athletes who suffered from ECS were either enrolled as freshmen/sophomore standing or transfers from other universities. Sports medicine practitioners and coaching staffs must recognize that this injury is prevalent in young collegeaged athletes who are not accustomed to increased workloads. A more concerted effort must be taken to ensure adequate time allotment for young athletes to properly adapt to the increased physical demands places on their bodies.

Acute Compartment Syndrome after Lower Leg Fracture

European Journal of Trauma, 2004

Background: In acute situations, fasciotomy can be done prophylactically or as early therapeutic decompression, the latter being performed as soon as the first symptoms of compartment syndrome are present. Patients and Methods: Results of fasciotomy after lower leg fracture performed between 1992 and 2001 were reviewed with emphasis on the efficacy of treatment and morbidity of the procedure sec. Patients, divided into a prophylactic group (A) and a therapeutic fasciotomy group (B), were interviewed and examined, focusing on late sequelae of compartment syndrome and of the fasciotomy sec. Results: 52 patients were followed up after a median period of 40 months, 18 in group A and 34 in group B. All fractures in group A were operated within 24 h, one third of patients in group B underwent surgery later. In group A, one short foot syndrome was found. In group B, five amputations were performed for ischemic muscle necrosis, two short foot syndromes were observed, and five legs showed other late compelling signs of manifest compartment syndrome. In the 31 legs without sustained compartment syndrome, only seven had no fasciotomy-related abnormalities besides a scar; reduced endurance and swelling were most frequently found. An iatrogenic superficial peroneal nerve lesion was diagnosed in seven legs. Conclusion: Outcome after prophylactic fasciotomy seems to be superior to that after early therapeutic decompression. Though prophylactic fasciotomy is effective, its morbidity is quite high, with long-term consequences in three quarters of patients.

Current thinking about acute compartment syndrome of the lower extremity

Canadian journal of surgery. Journal canadien de chirurgie, 2010

Acute compartment syndrome of the lower extremity is a clinical condition that, although uncommon, is seen fairly regularly in modern orthopedic practice. The pathophysiology of the disorder has been extensively described and is well known to physicians who care for patients with musculoskeletal injuries. The diagnosis, however, is often difficult to make. In this article, we review the clinical risk factors of acute compartment syndrome of the lower extremity, identify the current concepts of diagnosis and discuss appropriate treatment plans. We also describe the Canadian medicolegal environment in regard to compartment syndrome of the lower extremity.

Neglected acute post exertional anterior compartment syndrome: a case report

The Medical journal of Malaysia, 1985

A case of Acute Post Exertional Anterior Compartment Syndrome of the leg, seen five days after the onset of symptoms is presented. Decompression with delayed closure was done. There was only sensory recovery. However functional recovery at one year was good. Acute Post Exertional Compartment Syndrome cases are diagnosed late due to the lack of awareness, the paucity of radiological features, and the presence of intact peripheral pulses. A review of the literature revealed no previous documentation from SouthEast Asia. CASE REPORT E.C. was a 26-year-old Indian male who, whilst playing a game of football, noticed a sudden onset of pain in the anterior aspect of his right leg. The pain came on about fifteen minutes after the onset of the game. On finishing the game with difficulty, he noticed weakness of dorsiflexion of the right foot and felt that the dorsum of his foot was numb. He attended the local hospital where the X-ray did not reveal

Surgical Management of Exertional Anterior Compartment Syndrome of the Leg

West Indian Medical Journal, 2013

Objective: To describe the characteristic presentation of exertional leg pain in athletes and to discuss the diagnostic options and surgical management of exertional anterior compartment syndrome of the leg in this group of patients. Methods: Data from a series of athletes presenting with exertional leg pain were analysed and categorized according to aetiology. Results: Sixty-six athletes presenting with exertional leg pain in 102 limbs were analysed. Sixteen patients in a first group of 20 patients with a provisional diagnosis of exertional anterior compartment syndrome of the leg underwent a closed fasciotomy with complete resolution of symptoms. A second group of 42 patients were diagnosed as medial tibial stress syndrome and a third group of four patients had confirmed stress fracture of the tibia. Conclusion: Exertional leg pain is a common presenting complaint of athletes to sports physicians and physiotherapists. Careful analysis can lead to an accurate diagnosis and commencement of effective treatment. Exertional anterior compartment syndrome can be successfully treated utilizing a closed fasciotomy with a rapid return to sport.

Delay in diagnosis of acute on chronic exertional compartment syndrome of the leg

MUSCULOSKELETAL SURGERY, 2009

Exertional compartment syndrome is most commonly described in its chronic form in the young sportive patient. The acute form is a lot rarer and usually only unilateral. We report a case in which a chronic compartment syndrome became acute after intense effort. This was diagnosed rather late due to the lack of knowledge about this syndrome. The necrosis noticed during the fasciotomy was removed by iterative interventions. The wound was left in secondary healing because the patient refused a flap. Upon the patient's last follow-up visit, the wound was healed, but he had a complete deficit in dorsal flexion of the ankle, a foot drop and consequently a steppage gait.

Compartment syndrome with foot ischemia after inversion injury of the ankle

Journal of Vascular Surgery, 2007

This article reports the case of a 17-year-old girl who presented with compartment syndrome and acute ischemia of the foot after a minor ankle sprain. The suspected cause of compartment syndrome was secondary emergence of swelling and palsy of the foot. The posterior tibial and dorsalis pedis pulses were nonpalpable. The syndrome was confirmed by measurement of the pressures in the compartments of the foot, which were >30 mm Hg. Foot fasciotomy was successfully performed by using a three-incision technique. In contrast with previous case reports, no bone or vessel lesion was detected to explain the onset of a compartment syndrome. To our knowledge, this is the first case report compartment syndrome of the foot after an isolated minor ankle injury. Physicians should be aware of the possibility of compartment syndrome of the foot emerging irrespective of the severity of the initial trauma. ( J Vasc Surg 2007;46:369-71.)