Question:Last month, I developed an unusual case of compartment syndrome of the foot. No one knows exactly what brought it on. I've never had anything like this before, but I was training for a triathlon. It's possible I overdid it. My question is -- could I have gotten over this without surgery?
Answer:Compartment syndrome is an acute medical problem. Swelling and loss of blood supply to an area of confined muscle define the condition. It develops following injury, surgery or in many cases, repetitive motion.
Increased pressure caused by inflammation within the confined space of a fascial compartment cuts off blood supply to the area. Without prompt treatment, nerve damage and muscle necrosis (death) can occur.
This condition is most commonly seen in the anterior compartment (front of the leg or shin) and posterior compartment (back) of the leg. It can occur anywhere there are groups of muscles contained within the tight boundaries of connective tissue.
The connective tissue doesn't stretch so any bleeding or inflammation in the area can cause the pressure inside the compartment to rise rapidly. Once the pressure starts to rise in one compartment, it can rise in others as well. Fasciotomy to cut the fascia around the compartment and relieve the pressure may be required. This is a decompressive procedure.
Fractures, hemorrhage, too-tight casts, crush injuries, burns, and injection drug use are some of the ways traumatic compartment syndromes develop. In your case, it could be a case of exertional compartment syndrome.
Compartment syndrome can occur in a runner as a result of repetitive heavy use of the muscles. It's not usually an emergency. But the loss of circulation can cause temporary or permanent damage to nearby nerves and muscle. In severe cases, long-term deformities of the foot can develop from nerve damage and muscle contractures.Hermes H. Miozzari, MD, et al. Acute, Exertional Medial Compartment Syndrome of the Foot in a High-Level Athlete. A Case Report. In The American Journal of Sports Medicine. May 2008. Vol. 36. No. 5. Pp. 983-986.
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