Compartment syndrome chronic venousT79.6
Synonym(s)
Chronic venous compartment syndrome; Compartment sequence; Compartment syndrome; Lodge Syndrome
DefinitionThis section has been translated automatically.
Ischemia of the (lower leg) muscles due to pressure increase (< 42 mm Hg) within the closed fascia in CVI . Most frequently affected: tibialis anterior compartment, forearm extensor compartment and posterior and medial tibial tibial edge compartment.
EtiopathogenesisThis section has been translated automatically.
Dermatoliposclerosis in chronic leg ulcers involving the fascia cruris leads to external compression of vessels. Development slowly over years.
Clinical featuresThis section has been translated automatically.
- Painful swelling, redness, hardening and pressure dolence of the affected muscle group after stress or trauma. Increase of the subfascially measured tissue pressure. Increase or triggering of pain by passive stretching of the ischemic musculature. Paresis of the affected musculature. Sensitive and motor disturbances in the area where the nerves running in the loge spread due to pressure lesion.
- In case of delayed surgical intervention ischemic muscle necrosis with symptomatic myoglobinuria and elevation of CK in serum. Persistent motor deficit and contracture of the corresponding muscles. If necessary, permanent sensitive and motor deficits in the area supplied by the nerves passing through the loge.
HistologyThis section has been translated automatically.
Necrosis of the muscle cells, glucogen depletion.
DiagnosisThis section has been translated automatically.
Pressure measurement with special electrode (e.g. Sensodyn/brown), possibly CT. The CT-image shows a large-area caking of the fascia cruris with the subcutaneous fat tissue.
TherapyThis section has been translated automatically.
Generous fascial splitting and evacuation of the already necrotic muscle. After fascial resection, a relatively fast recovery of the musculature occurs. In case of extensive muscle loss, danger of acute kidney failure (crush syndrome).
Progression/forecastThis section has been translated automatically.
Depending on the time of the intervention. Advantageous for immediate surgical intervention.
LiteratureThis section has been translated automatically.
- Dickson KF et al (2003) Noninvasive measurement of compartment syndrome. Orthopedics 26: 1215-1218
- Hach et al (2000) Compartment syndromes in phlebology. Phlebology 1: 7-24
- Hach W et al (2001) Chronic venous compartment syndrome. Central bl chir 126: 472-475
- Pflug JJ et al (1990) The resting interstitial pressure in primary varicose veins. J Vasc Surgery 11: 411-7
- Quarfordt P, Eklöf B, Ohlin P (1982) Reference values for intramuscular pressure in the lowe leg in man. Clin Physiol 2: 427-434
- Touliopolous S et al (1999) Lower leg pain. Diagnosis and treatment of compartment syndromes and other pain syndromes of the leg. Sports Med 27: 193-204