Clinical Orthopaedics and Related Research®

, Volume 468, Issue 4, pp 940–950 | Cite as

Compartment Syndrome of the Lower Leg and Foot

  • Michael FrinkEmail author
  • Frank Hildebrand
  • Christian Krettek
  • Jurgen Brand
  • Stefan Hankemeier
Symposium: Recent Advances in Foot and Ankle Surgery


Compartment syndrome of the lower leg or foot, a severe complication with a low incidence, is mostly caused by high-energy deceleration trauma. The diagnosis is based on clinical examination and intracompartmental pressure measurement. The most sensitive clinical symptom of compartment syndrome is severe pain. Clinical findings must be documented carefully. A fasciotomy should be performed when the difference between compartment pressure and diastolic blood pressure is less than 30 mm Hg or when clinical symptoms are obvious. Once the diagnosis is made, immediate fasciotomy of all compartments is required. Fasciotomy of the lower leg can be performed either by one lateral incision or by medial and lateral incisions. The compartment syndrome of the foot requires thorough examination of all compartments with special focus on the calcaneal compartment. Depending on the injury, clinical examination, and compartment pressure, fasciotomy is recommended via a dorsal and/or medial plantar approach. Surgical management does not eliminate the risk of developing nerve and muscle dysfunction. When left untreated, poor outcomes with contractures, toe deformities, paralysis, and sensory neuropathy can be expected. In severe cases, amputation may be necessary.

Level of Evidence: Level III. See Guidelines for Authors for a complete description of levels of evidence.


Compartment Syndrome Medial Compartment Compartment Pressure Acute Compartment Syndrome Validate Outcome Measure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© The Association of Bone and Joint Surgeons® 2009

Authors and Affiliations

  • Michael Frink
    • 1
    Email author
  • Frank Hildebrand
    • 1
  • Christian Krettek
    • 1
  • Jurgen Brand
    • 2
  • Stefan Hankemeier
    • 1
  1. 1.Department of TraumatologyHannover Medical SchoolHannoverGermany
  2. 2.Praxisklinik UelzenUelzenGermany

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