The effect of ankle position on intracompartmental pressures of the leg

Objectives: We investigated differences in the intracompartmental pressures (ICP) of the leg in relation to various positions of the ankle joint in patients with chronic exertional compartment syndrome (CECS). Methods: The study included 16 patients (10 males, 6 females; mean age 30 9 years, range 16 to 48 years) actively involved in various sports. Intracompartmental pressures were monitored with the use of slit catheters connected to a pressure transducer in 28 anterior and 14 deep posterior compartments before and after exercise during the following positions of the ankle joint: relaxed-resting, passive plantar flexion, neutral, and passive dorsiflexion. Alterations in ICP were assessed with reference to that measured in the relaxed-resting position Of the ankle. Results: Significant increases in ICP were observed in both anterior and deep posterior compartments during dorsiflexion of the ankle, being 9.1 +/- 10.6 mmHg (p=0.0001) and 8 +/- 10.3 mmHg (p=0.001) in the anterior compartment, and 6.4 +/- 4.4 mmHg (p=0.0001) and 7.2 +/- 4.3 mmHg (p=0.001) in the deep posterior compartment before and after exercise, respectively. No significant increases were found in other positions of the ankle (p>0.05). While the lowest values of ICP were noted in the relaxed-resting position, plantar flexion of the ankle was associated with decreased ICP pressures. Conclusion: Dorsiflexion of the ankle increases ICP significantly in both anterior and deep posterior compartments. The results of this study may have clinical implications for the conservative management of both CECS and tibial fractures.