Quantitative Analysis of Compartments in the Leg and Implications for Trauma Surgery

Abstract

Compartment syndrome is characterized as an excess in swelling leading to an increase in pressure in a limited space and a lower extremity fasciotomy is performed to mitigate the effects. A two-incision fasciotomy is performed on the medial and lateral sides of the leg, accessing the posterior superficial, deep superficial, anterior and lateral compartments respectively. Ongoing studies have shown the lateral compartment is commonly decompressed incorrectly. This error has led to the hypothesis that there is variability in septum position and that using the fibula as a landmark can lead to erroneous incision placement in patients. CTA scans were analyzed to assess septum position. Findings indicate that the septum position shifts anteriorly progressing distally down the leg, indicating variability at different points in the leg. If surgeons do not take septum variability into consideration when decompressing the lateral compartment, this can lead to incorrect decompression of the lateral compartments.