The arterial and venous color Doppler study was within normal limits. Pulses were palpable at the ankle but feeble and ankle pressure 20 mmHg. There were no signs of compartment syndrome on palpation. On clinical examination, the limb was warm, duskiness of entire right foot below the level of the ankle with impending gangrene. Her creatinine kinase level was within normal limits. All the routine investigations were within normal limits. ![]() She was treated as a case of deep vein thrombosis outside and then referred to our center. There was no history of any trauma, infection, animal bites, or any risk factor for deep venous thrombosis. We present the case of a 40-year-old female patient with no comorbidities, who was referred to us with complaints of pain in the right foot below the malleolar level for 2-day duration associated with black discoloration of the entire foot for 7 h. We present the case of a middle-aged female who presented with pregangrenous changes in the foot without any obvious signs of compartment syndrome. Paralysis, pulselessness, and paresthesias present late in the disease process, often after irreversible nerve and muscle damage, and should not routinely be part of the diagnostic criteria for acute compartment syndrome. ![]() Rapid diagnosis and treatment can be life or limb saving. Lower extremity compartment syndrome is not common without obvious signs and has the potential to cause devastating morbidity for patients. The below-knee leg is the most likely compartment to develop acute compartment syndrome, followed by the forearm, thigh, and arm. Compartment syndrome can occur in any area of the body with closed compartments. Available from: Ĭompartment syndrome occurs when the pressure within a defined compartmental space increases past a critical pressure threshold, thereby decreasing the perfusion pressure to that compartment. Indian J Vasc Endovasc Surg 2021 8:261-3. ![]() Lower leg compartment syndrome detected by peripheral angiography. Keywords: Compartment syndrome, creatine phosphokinase, fasciotomy, foot Advanced diagnostic techniques like peripheral angiography at the earliest can be lifesaving. The classic signs of compartment syndrome, the “6 P's,” can be deceiving. High suspicion is needed to diagnose the condition. Any delay in evaluating and treating patients with lower extremity compartment syndrome can be devastating for the patient. ![]() Severe damage to the nerve and blood vessels around a muscle can cause the muscle to die and amputation might be necessary.Compartment syndrome occurs when the pressure within a defined compartmental space increases past a critical pressure threshold jeopardizing the blood supply. If the pressure becomes great enough, blood flow to the muscle can be blocked, leading to a condition known as compartment syndrome. Blood vessels and nerves can also be affected by the pressure caused by any swelling in the leg. The thickness of the fascia can give problems when any inflammation present in the leg has little room to expand into. Due to the great pressure placed on the leg, from the column of blood from the heart to the feet, the fascia is very thick in order to support the leg muscles. The fascia also separates the skeletal muscles from the subcutaneous tissue. The septa are formed from the fascia which is made up of a strong type of connective tissue. Įach compartment contains connective tissue, nerves and blood vessels. The lower leg is divided into four compartments by the interosseous membrane of the leg, the anterior intermuscular septum, the transverse intermuscular septum and the posterior intermuscular septum. All of the muscles within a compartment will generally be supplied by the same nerve. The compartments usually have nerve and blood supplies separate from their neighbours. The compartments are divided by septa formed from the fascia. The fascial compartments of the leg are the four fascial compartments that separate and contain the muscles of the lower leg (from the knee to the ankle).
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