Board Review: Compartment Syndrome

 

Board Review: Compartment Syndrome  

 

A 25 y/o male presents to your emergency department after falling from a light pole during the Philadelphia Eagles Super Bowl parade.  An XRAY helps you diagnose a left tibial shaft fracture and you apply the appropriate splint.  After 1 hour the patient complains of worsening pain and “numbness” in the leg.  On physical exam you note a firm, tender, and swollen left lower leg with a compartment pressure of 40 mmHg.  You note decreased sensation in the 1st webspace of the left foot.  Which compartment of the left lower leg is most likely affected?  (scroll down for the answer) 

  A) Anterior

  B) Lateral

  C) Deep Posterior 

  D) Superficial Posterior 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The correct answer is A) Anterior Compartment. 

The Anterior Compartment of the lower leg contains the Deep Fibular (Peroneal) Nerve which is responsible for sensation of the 1st webspace of the foot. 

 

Compartments of the Lower Leg with Associated Nerves 

  1. Anterior 

- Deep Fibular (Peroneal) Nerve - sensation of 1st webspace

     2. Lateral

- Superficial Fibular (Peroneal) Nerve - sensation of lateral aspect of lower leg and dorsum of foot 

     3. Deep Posterior 

- Posterior Tibial Nerve - sensation of plantar aspect of foot

     4. Superficial Posterior 

- Sural Cutaneous Nerve - sensation of lateral aspect of foot 

 

 

 

Stapczynski, J. Stephan,, and Judith E. Tintinalli. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: McGraw-Hill Education LLC., 2011.