- There are 9 foot compartments.
- Prolonged ischemia due to unidentified compartment syndrome may lead to irreversible destruction of tissue.
- Usually associated with calcaneal fracture or major midfoot fracture.
- Intense pain and swelling.
- Associated traumatic injury is usually present.
- Decreased sensation to the toes.
- Movement of toes causes more pain.
- Absent pulse or complete anaesthesia are late signs of compartment syndrome.
Tests and Imaging
- X-ray and MRI will demonstrate associated underlying injury but will not be able to specifically diagnose compartment syndrome.
- Compartment pressure monitoring is used to diagnose compartment syndrome.
- Pressure monitoring within the compartment less than diastolic blood pressure (less than 20-25 mmHg is suggestive of compartment syndrome)
- Refer to Emergency Department.
- Avoid activity in the area.
- Elevation of the lower extremity to the level or above the heart to lower mean arterial pressure reducing oxygen perfusion.
- Pneumatic intermittent impulse compression device to decrease interstitial pressure, improve venous return, and enhance arterial flow increasing osmotic resorption of the interstitial fluid.
- Emergency surgery for release or fasciotomy.