Anterior compartment syndrome of the lower leg

Anterior compartment syndrome of the lower leg is a condition characterized by increased pressure within the anterior compartment of the lower leg, which can lead to muscle and nerve damage. This condition can be either acute or chronic, with the acute form being a medical emergency.

Causes

The anterior compartment of the lower leg contains muscles that are involved in dorsiflexion of the foot (lifting the foot upwards). Anterior compartment syndrome occurs when there is an increase in pressure within this compartment, which can be caused by trauma, such as a fracture or a crush injury, prolonged periods of exercise, especially in untrained individuals, or external compression from tight bandages or casts.

Symptoms

Symptoms of anterior compartment syndrome include severe pain in the lower leg that is disproportionate to the injury or activity level, pain on dorsiflexion of the foot, a feeling of tightness or fullness in the muscle, numbness or weakness in the foot, and in severe cases, visible bulging of the muscle.

Diagnosis

Diagnosis of anterior compartment syndrome is primarily clinical, based on the symptoms and physical examination. In some cases, compartment pressure measurements may be performed to confirm the diagnosis. This involves inserting a needle connected to a pressure monitor into the compartment to measure the pressure within.

Treatment

The treatment for acute anterior compartment syndrome is immediate surgical intervention, known as a fasciotomy, to relieve the pressure within the compartment. This procedure involves making an incision in the skin and the fascia of the affected compartment to allow the muscle to expand and relieve the pressure. Chronic compartment syndrome, which is less severe, may be managed with physiotherapy, modification of exercise routines, or in some cases, surgery.

Prevention

Prevention of anterior compartment syndrome involves avoiding the risk factors, such as gradually increasing the intensity of exercise routines, avoiding tight bandages or casts, and seeking immediate medical attention for any leg injuries.