Compartment syndrome following recurrent ankle inversion injury.

Drs Creighton and Bach and Mr Kinder are from the Division of Sports Medicine, Rush University Medical Center, Chicago, Ill. Reprint requests: Bernard R. Bach, Jr, MD, 1725 W Harrison St, Ste 1063, Chicago, IL 60612. Compartment syndrome is an elevation of the interstitial pressure in a closed osseofascial compartment that results in microvascular compromise. The condition may be further classifi ed as either acute or chronic. Common causes of acute compartment syndrome include fractures, severe blunt soft tissue trauma, arterial injury, limb compression, and burns. Chronic compartment syndrome is caused by increased muscle volume most commonly occurring during exercise. The diagnosis of an acute compartment syndrome is made by clinical signs and can be further confi rmed by compartment pressure measurements.1-6 Measurements of compartment pressure are used for the evaluation of a compartment in which the diagnosis of compartment syndrome cannot be made or ruled out with certainty, as in a patient with altered mental status or in chronic exertional compartment syndrome.3 Signs and symptoms of acute compartment syndrome include pain out of proportion, increased use of analgesics, pain with passive muscle stretching, paresis, paresthesia, and diminished pulses. Pulses usually remain intact due to arterial pulses remaining higher than the pressure of the compartment compressing the artery. The following case report describes the clinical presentation and treatment of compartment syndrome following an inversion injury of the ankle.