ABSTRACT
Compartment syndrome of the foot (CSF) is a surgical emergency, with high risk of
morbidity and poor outcome, including persistent neurologic deficits or amputation.
Uncertainty remains regarding surgical approaches, pressure monitoring values, and
the extent of surgical treatment. This review provides a summary of the current knowledge
and reports evidence-based diagnostic and therapeutic management options for CSF.
Articles describing CSF were identified from MEDLINE, PubMed, and Cochrane databases
up until February 2018. Experimental and original articles, systematic and nonsystematic
reviews, case reports, and book chapters, independent of their level of evidence,
were included. Crush injuries are the leading cause of CSF, but CSF can present after
fractures of the tarsal or metatarsal bones and dislocations of the Lisfranc or Chopart
joints. CSF is often associated with persistent neurologic deficits, claw toes, amputations,
and skin healing problems. Diagnosis is made after accurate clinical evaluation combined
with intracompartmental pressure monitoring. A threshold value of <20 mmHg difference
between the diastolic blood pressure and the intracompartmental pressure is considered
diagnostic. Management consists of surgery, whereby 2 dorsal incisions are combined
with a medioplantar incision to the calcaneal compartment. The calcaneal compartment
can serve as an “indicator compartment,” as the highest-pressure values can regularly
be measured within this compartment. Appropriately powered studies of CSF are necessary
to further evaluate and compare diagnostic and therapeutic options.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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