Compartment Syndrome Of The Foot

2.  Acute compartment syndrome of the foot
was first described in the literature in 1981
 Increase of pressure in closed myofascial
compartment
 An orthopedic emergency as prolonged
ischemia may lead to irreversible destruction
of myoneural tissue and subsequent fibrosis

3.  Consist of 9 compartments:
› Medial
› Lateral
› Central
 Superficial
 Deep
› Interosseus(4)
› Calcaneal

4.  Flexor Hallucis Brevis
 Adductor Hallucis Muscle

5.  Abductor Digiti Minimi
 Flexor Digiti Minimi Brevis

6.  Superficial
› Flexor Digitorium Longus and
Brevis Muscle

7.  Deep
› Olique head of adductor hallucis muscle

8.  Quadratus Plantae Muscle

9.  Each in-between the metatarsal bone

10. Injury Edema/Hematoma Increase interstitial
pressure
Decrease perfusion
Ischemic
 Calcaneum Fracture
 Liscfrac Injury
 Crush Injury
 Cast
 Snake Bite

11.  Pain out of proportion
 Pareasthesia
 Pulseless
 Pallor

12.  Clinical findings
› High index of suspicion
 Intra-compartmental pressure monitoring
device
› >30mmHg
› greater than 10- 30
mmHg less than the
diastolic pressure

13.  Fasciotomy
› Double Dorsal Incision
 2nd incision lateral to
4th MTB
 1st incision medial to
2nd MTB

14. releases 1st and 2nd
interosseous, medial,
and deep central
compartmen
releases 3rd and 4th
interosseous, lateral,
superficial
central compartments

15.  Fasciotomy
› Medial Incision
› Calcaneal Incision

17.  Orthobullets (http://www.orthobullets.com/trauma/1065/foot-compartment-
syndrome)
 AO Foundation
(https://www2.aofoundation.org/wps/portal/surgery?showPage=redfix&bon
e=Foot&segment=Calcaneus&classification=82-
Special%20considerations&treatment=&method=Special%20consideration
s&implantstype=hidden&approach=&redfix_url=1420643218961&Languag
e=en)
 American Association of Orthopedic Surgeons
(http://www.aaos.org/news/bulletin/janfeb07/clinical1.asp)