FOOT COMPARTMENT SYNDROME: A RARE PRESENTATION TO THE EMERGENCY DEPARTMENT

Background: Compartment syndrome of the foot is a rare but life- and limb-threatening condition that is often difficult to diagnose. The common signs and symptoms of compartment syndrome are pain out of proportion to the injury, pain with passive stretch of the compartment, paresis, paresthesias, and often, intact pulses. Foot compartment syndrome is often caused by traumatic injuries, and the clinical presentation may be confusing in this setting. The foot contains nine compartments, which should all be assessed for elevated compartment pressures. Definitive management is fasciotomy. Prompt recognition, diagnosis, and treatment are essential to prevent devastating complications. Objectives: This article discusses the key components of presentation, diagnosis, and management of foot compartment syndrome. Case Report: A patient presented to the Emergency Department (ED) with a crush injury of his foot. He had significant swelling and pain in his foot, but no fractures were identified on X-ray study. Given the severity of his injury and pain, foot compartment pressures were measured to accurately diagnose foot compartment syndrome. The patient underwent fasciotomies of the foot within 3 h of presentation to the ED and suffered no sequelae at the time of follow-up in clinic. Conclusion: Foot compartment syndrome is a surgical emergency that can be difficult to diagnose. Early diagnosis with compartment pressure measurements is crucial, as definitive management with fasciotomies can prevent long-term sequelae. (c) 2013 Elsevier Inc.