Younger patients (≤ 35 years of age) are also at a greater risk to ACS due to having tighter fascia and larger muscle mass and as they are prone to injuries or accidents Clinically Relevant Anatomy Male patients are ten times more impacted by ACS than females, possibly due to males having larger muscle mass within a fixed compartment. Ĭhronic exertional compartment syndrome is typically considered a rare cause of lower extremity pain, with a reported incidence rate in active patients presenting with exercise-induced leg pain to be 33% The anterior compartment is affected more frequently than the lateral, deep and superficial posterior compartments. If this pressure elevates to 30 mmHg or more, small vessels in the tissue become compressed, which leads to reduced nutrient blood flow, ischemia and pain. During strenuous exercise, there can be up to a 20% increase in muscle volume and weight due to increased blood flow and oedema, so pressure increases. Īny condition that results in an increase of pressure in a compartment can lead to the development of acute (ACS) or chronic exertional compartment syndrome (CECS).

The definitive treatment of ACS is timely fasciotomy. Hallmark symptoms of ACS include the 6 P’s: pain, poikilothermia, pallor, paresthesia, pulselessness, and paralysis. Late findings of ACS can lead to limb amputation, contractures, paralysis, multiorgan failure, and death. Although benign, the refractory nature of CECS often results in a substantial portion of patients ultimately electing to proceed with fasciotomies.

Chronic exertional compartment syndrome (CECS) occurs in the setting of recurrent, reversible ischemic episodes following the cessation of activity resulting in the predictable decrease in fascial compartment pressures.Key structures within the fascial compartment affected by increased compartment pressures include muscles, nerves and vasculature. Lower leg ACS is a condition in which increased pressure within a muscle compartment surrounded by a closed fascial space leads to a decline in tissue perfusion and compromises motor and sensory function. ] Acute compartment syndrome (ACS) of the lower leg is a time-sensitive orthopedic emergency that relies heavily on precise clinical findings.There are two distinct forms of compartment syndromes, acute and chronic types.

Compartments of leg innervation