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Trauma to the leg

8 Min Clinical Anatomy Lecture

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Trauma to the leg

  1. 1. Trauma to the Leg Gazi Rashid, M4 grashid@emory.edu Dec 12th 2018 ASP Clinical Anatomy
  2. 2. Objectives Use a common trauma injury case to… 1. Understand the basic pathophysiology of compartment syndrome 2. Focus on the neurovasculature of a single compartment 3. Walk through the treatment guided by anatomical landmarks
  3. 3. Compartments in the Lower Leg 1 2 3 4
  4. 4. A common trauma patient
  5. 5. ABCDE
  6. 6. Whew… • Went through ABCDEs • Arteries and veins intact • Broken tibia • Called Ortho
  7. 7. What now?
  8. 8. Compartment Syndrome
  9. 9. Compartment Syndrome
  10. 10. Compartments in the Lower Leg
  11. 11. What’s the treatment?
  12. 12. Fasciotomy
  13. 13. Objectives Use a common trauma injury case to… 1. Understand the basic pathophysiology of compartment syndrome 2. Focus on the neurovasculature of the anterior compartment 3. Walk through the treatment guided by anatomical landmarks
  14. 14. Review the Qs 1. What’s the major artery passing through the anterior compartment that eventually becomes the dorsalid pedis? 2. The Common Peroneal nerve gives off what branch in the Lateral compartment and what branch in the Anterior compartment? 3. CS of the anterior compartment presents as numbness or tingling where? 4. Foot drop occurs with damage to the deep peroneal because which muscle is affected?
  15. 15. Links 1. Acute Compartment Syndrome of the Lower Leg: A Review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4970751/ 2. Lower extremity compartment syndrome: https://tsaco.bmj.com/content/2/1/e000094 3. Two Incision Four Compartment Fasciotomy: https://www.youtube.com/watch?v=- 1NDJkFH1vM&ab_channel=operationgivingback
  16. 16. Things to Know • Vasculature • Anterior tibial artery is the blood supply for this compartment…terminal branch of popliteal artery…passes anteriorly through gap in superior part of interosseous membrane, at malleoli  Becomes dorsal artery of foot • The posterior tibial artery and its biggest branch the fibular artery supply the posterior compartment. • Know nerves • Deep peroneal - Extends in to foot to supply extensor digitorum brevis and extensor hallicus brevis and skin b/ 1st and 2nd toes • Goes to tibialis anterior  dorsiflexes  foot drop

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