Acute and chronic leg Compartment Syndrome - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the condition of compartment syndrome.
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Acute and Chronic Leg Compartment Syndrome
Compartment syndrome is a condition in which increased pressure within a closed space compromises the circulation to the tissues contained within that space. The condition of compartment syndrome can affect any muscle compartment within the body, however it most commonly affects the lower leg. Almost any injury can cause compartment syndrome, including injury resulting from vigorous exercises, however the most common cause of compartment syndrome is due to fracture and soft tissue injuries. Edema and hemorrhage cause fluid accumulation, which elevates the compartment pressure and this causes occluding of the blood vessels and compression on the nerves. With clinical suspicion of the compartment syndrome, the compartment pressure is measured. An absolute pressure of 30mmHg or higher, or within 30 mmHg of the diastolic blood pressure is considered to be diagnostic of acute compartment syndrome. Without urgent decompression, tissue ischemia, necrosis, and functional impairment will occur. Anatomy is crucial in the treatment of compartment syndrome. The four compartments of the leg include anterior compartment, lateral compartment, superficial posterior compartment, and deep posterior compartment. Fasciotomy is the treatment of choice for compartment syndrome. Complete decompression of the lower leg is accomplished through a double incision, four compartment fasciotomies. The first incision is placed half way between the fibular shaft and the tibial crest. The fascia, anterior and posterior to the septum is opened transversely. The anterior compartment is released first, followed by release of the lateral compartment. Release the anterior compartment and the lateral compartment. Care should be taken not to injure the superficial peroneal nerve located within the lateral compartment. The second incision is made medial to the previous incision 2 cm posterior to the posterior tibial margin. Care should be taken not to injure the saphenous nerve and vein. The fascia, anterior and posterior to the septum, is opened transversely. The superficial posterior compartment is released first, followed by release of the deep posterior compartment. The double incision, four compartment fasciotomy is now complete. Chronic exertional compartment syndrome (CECS) is an exercise induced condition that is different from acute compartment syndrome. In CECS patients, the resting intra-compartmental pressure is usually greater than 15mmHg. Pain begins within 20 minutes of exercise. Burning, cramping, or aching pain and tightness develops, leading to cessation of the activity. Pain, swelling, claudication, and paresthesia occurs after exercise. Compartment pressure that remains over 30mmHg one minute after the end of exercise or pressure that remains over 20mmHg for longer than 5 minutes after the end of exercise is considered diagnostic of CECS. While initial treatment can be conservative, a fasciotomy is probably the only proven successful treatment.

[@bjonktfoisper]

thank you for an excellent clear and concise description of compartment syndrome. no music, no fancy crap or silly jokes just good ole expertise.

[@armeaf8620]

No word can thank your efforts....you represent a reliable fast recall operative ortho refrence...Go on for more sir

[@customizedtrainingservices2079]

Thank you so much for the straight forward video. I developed an acute case of compartment syndrome in my lower left leg about 30 months ago. I was just pushing a wheelbarrow. I felt a slight strain in my leg and two days later it hit me. I am 77 years old and not an athlete. They performed an emergency fasciotomy with two long incisions and employed a wound vac. It took me about two months before I could walk again. It was a very painful process. After watching your video, I am able to more completely understand this condition. Thank you again!!!

[@elizabethdavid9964]

I recently discovered your videos. I find them very very helpful. I'm working in orthopaedics and information I get from your videos help with my recall especially because I learn better visually. Thank you Professor....much respect from the UK

[@kingalexanderia3365]

Thanks professor Ibrahim........ *for these valuable information* ...

[@SkydivingSquid]

I have never had CECS until recently. I was running marathons at a very fast pace 2 years ago. I took a year off of running and got into weight lifting. All of the sudden, now when I run my leg pressure skyrockets causing my to stop after about 10-15 minutes, and preventing flexion of my foot. I have developed fascial hernias in my leg which get worse during this time. Been to physical therapy for a couple months now with slow progress to "strengthen the muscles" though I am not sure it's doing much. Honestly, Im perplexed why Id get this now.

[@simont6439]

How did it go? Did you try to stop weight lifting and did that enable you to run without symptoms?

[@ItsMe-jr6kd]

thank you doctor please we need a video about instruments in orthopedic surgery

[@zeynabsaad]

Very nicely explained 👏 why so less likes...

[@sravi24]

Thank you Professor

[@sateeshburada33]

Thank you sir...

[@gamaltaher9714]

Good, thanks

[@PrinceAliahsan]

I think I suffer from the later, being the chronic exertional compartment syndrome

[@juvecrow7995]

So what if we close the hole instead of opening the rest of it will it be enough and how it's will effect the leg

[@wendolyneutterback3400]

Is it typical to have the leg/calf with CECS be larger than the other? That is the case for me. The calf with CECS is visibly larger than my opposite calf. I had a fasciotomy 2 years ago and am having the same symptoms again and have concerns that the muscle will continue to become larger in my affected leg. TIA for your input.

[@jonnyboy4662]

Thanks for this enlightening video, could you please tell me how to identify the difference between Chronic Compartment Syndrome and Intermittent Claudication.

[@BombshellElf]

No doctor can give me answers. In pain everyday all day. Many different types of pain, including the calf feeling like it's going to snap my shin in half from pressure within. Walking with limp now. Been in right calf for 11 yrs, pain is started to radiate up into my thigh and hip. Doctor sent me to physical therapy for a month... Told them it's making pain worse. 2 weeks after they agreed that physical therapy was not helping, I got meligaria paresthetica!! I pinched nerve at the top of thigh/hip. So still have extreme calf pain also with extreme thigh hip pain. Question for anyone here... DOES THE MIDDLE OUTER SIDE OF YOUR CALF SNAP, CRACK OR POP? (Like a joint would) If so, does the pain become worse after?

[@adeyemibabatunde1814]

Meralgia paresthetica:

[@EvaK7]

👍🏻

[@randomclicks247]

👌👏👏