Der Unfallchirurg
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Ischemic muscle contracture after a compartment syndrome of the forearm and hand may result in severe loss of function. In addition to the established muscle contracture, a loss of nerve and vessel function can often be found. The clinical appearance depends on the involved muscles respectively compartments. Even though each case requires individual analysis of the clinical situation, the combination of Tsuge's classification with Holden's classification provides a more or less systematic approach to treatment that can be adapted to each case according to the severity of the contracture of the joints and muscles, the degree of nerve and vessel damage, the function of the remaining muscles and nerves, and the availability of other functioning muscles for reconstruction.
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Due to the unique anatomy and pathophysiology involved, a compartment syndrome (CS) of the lower leg and foot is prone to develop sequelae that demand operative reconstruction. Moreover, the two regions are closely related. Although research into various pathophysiological areas is revealing specific complexities, aspects of the foot's compartmental anatomy remain controversial, perhaps because of methodological reasons. This may result in particular practices for diagnosing and treating CS in this region, which are discussed in this article.