What is Anterior Compartment Syndrome?

Anterior compartment syndrome is a potentially serious medical condition characterized by extreme pain and swelling in the lower leg. This condition occurs when the pressure inside the fascial compartment which contains the muscles rises. In some cases, untreated anterior compartment syndrome can result in paralysis or loss of the limb, two very undesirable outcomes. There are a number of treatment options available to address this condition quickly and effectively.

The muscles in the body are surrounded by “compartments” made of fascia which protect the muscles and hold them in place. Fascia is not very stretchy, which is a good thing when someone is healthy, but when swelling starts to happen inside the compartment, the pressure limitations of the compartment can be reached quickly. One reason for swelling is strain or overuse which causes inflammation, and another cause is bleeding inside the compartment.

People with anterior compartment syndrome experience pain in the outside of the lower leg, especially after exercise. The pain may not subside after rest, and the leg will appear swollen. It can be hot to the touch and may appear glossy. Patients can also experience weakness, pain when they flex the feet or toes, and difficulty walking. Depending on the cause of the anterior compartment syndrome, the pain can reach very high levels very quickly as the pressure inside the fascial compartment skyrockets.

When a doctor diagnoses anterior compartment syndrome, one option for treatment is to prescribe drugs to bring down the inflammation, and to recommend that the patient rest until the condition is fully resolved. Supportive bracing can also be used, if the anterior compartment syndrome is caused by a postural problem. However, in some cases, surgery may be necessary. In the surgery, a small incision is made in the fascia to relieve the pressure, and suction may be used to pull out a buildup of blood and other fluids.

Surgery for anterior compartment syndrome can save the leg. In emergency situations, it may be indicated immediately, before a doctor has had time to order imaging studies or to fully examine the patient. In these situations, the doctor intervenes to save the leg while working to stabilize the patient. Acute anterior compartment syndrome which requires immediate can happen in the wake of a crush injury, car accident, or similar type of trauma. In these cases, the patient may also have other injuries which must be balanced when deciding what to treat when.