Anterior compartment syndrome of the lower leg
Encyclopedia
A compartment syndrome
is an increased pressure within a muscular compartment that compromises the circulation of the muscles.
l (and osseous) enclosure of the muscles. The anterior compartment syndrome of the lower leg
(often referred to simply as anterior compartment syndrome), can affect any and all four muscles of that compartment: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius.
This term is often mistakenly used to describe various related/proximal conditions, including Anterior Shin Splints
. It is important to distinguish between the two, as shin splints rarely causes serious health problems, while Anterior Compartment Syndrome can lead to irreversible damage.
The true compartment syndrome arises due to increased pressure within the unyielding anterior compartment of the leg
. The pressure obstructs venous outflow, which causes further swelling and increased pressure. The resultant ischemia
leads to necrosis
(death of tissue) of the muscles and nerves. The process can begin with swelling of the tibialis anterior, extensor hallucis longus, extensor digitorum longus, and/or the peroneus tertius muscles in response to strong eccentric contractions sufficient to produce postexercise soreness.
to become hot, stretched and glossy. Pain, paresthesia
s, and tenderness in both the ischemic muscles and the region supplied by the deep common fibular nerve
are exhibited by patients suffering from this condition. Sensitivity to passive stretch and active contraction are common, and tend to increase the symptoms.
(MD/DO), a doctor of podiatric medicine (DPM), or other qualified health care professional immediately so as to get the appropriate advice/treatment before serious damage occurs.
The 5 Ps of Anterior Compartment Syndrome:
Compartment syndrome
Compartment syndrome is a limb threatening and life threatening condition, defined as the compression of nerves, blood vessels, and muscle inside a closed space within the body . This leads to tissue death from lack of oxygenation due to the blood vessels being compressed by the raised pressure...
is an increased pressure within a muscular compartment that compromises the circulation of the muscles.
Pathology
A compartment space is anatomically determined by an unyielding fasciaFascia
A fascia is a layer of fibrous tissue that permeates the human body. A fascia is a connective tissue that surrounds muscles, groups of muscles, blood vessels, and nerves, binding those structures together in much the same manner as plastic wrap can be used to hold the contents of sandwiches...
l (and osseous) enclosure of the muscles. The anterior compartment syndrome of the lower leg
Human leg
The human leg is the entire lower extremity or limb of the human body, including the foot, thigh and even the hip or gluteal region; however, the precise definition in human anatomy refers only to the section of the lower limb extending from the knee to the ankle.Legs are used for standing,...
(often referred to simply as anterior compartment syndrome), can affect any and all four muscles of that compartment: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius.
This term is often mistakenly used to describe various related/proximal conditions, including Anterior Shin Splints
Shin splints
Shin splints or medial tibial stress syndrome refers to pain along or just behind the shins with sports that apply extreme pressure to the legs, such as gymnastics...
. It is important to distinguish between the two, as shin splints rarely causes serious health problems, while Anterior Compartment Syndrome can lead to irreversible damage.
The true compartment syndrome arises due to increased pressure within the unyielding anterior compartment of the leg
Fascial compartment
On the human body, the limbs can be divided into segments, such as the arm and the forearm of the upper limb, and the thigh and the leg of the lower limb.If these segments are cut transversely, it is apparent that they are divided into multiple sections...
. The pressure obstructs venous outflow, which causes further swelling and increased pressure. The resultant ischemia
Ischemia
In medicine, ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It may also be spelled ischaemia or ischæmia...
leads to necrosis
Necrosis
Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...
(death of tissue) of the muscles and nerves. The process can begin with swelling of the tibialis anterior, extensor hallucis longus, extensor digitorum longus, and/or the peroneus tertius muscles in response to strong eccentric contractions sufficient to produce postexercise soreness.
Symptoms
Diffuse tightness and tenderness over the entire belly of the tibialis anterior that does not respond to elevation or pain medication can be early warning signs and suggestive of Anterior Compartment Syndrome. Other common symptoms include excessive swelling that causes the skinSkin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
to become hot, stretched and glossy. Pain, paresthesia
Paresthesia
Paresthesia , spelled "paraesthesia" in British English, is a sensation of tingling, burning, pricking, or numbness of a person's skin with no apparent long-term physical effect. It is more generally known as the feeling of "pins and needles" or of a limb "falling asleep"...
s, and tenderness in both the ischemic muscles and the region supplied by the deep common fibular nerve
Common fibular nerve
The common fibular nerve , about one-half the size of the tibial nerve, is derived from the dorsal branches of the fourth and fifth lumbar and the first and second sacral nerves.It descends obliquely along the lateral side of the popliteal fossa to the head of the fibula,...
are exhibited by patients suffering from this condition. Sensitivity to passive stretch and active contraction are common, and tend to increase the symptoms.
Diagnosis
If these symptoms are observed/experienced it is important to contact a physician specializing in sports medicineSports medicine
Sports medicine is a branch of medicine that deals with physical fitness, treatment and prevention of injuries related to sports and exercise...
(MD/DO), a doctor of podiatric medicine (DPM), or other qualified health care professional immediately so as to get the appropriate advice/treatment before serious damage occurs.
The 5 Ps of Anterior Compartment Syndrome:
- Pain
- Pallor
- Paresthesia
- Pulselessness
- Paralysis (If not treated)