Anterior tibial compartment syndrome following femoral artery perfusion.

Anterior tibial compartment syndrome following femoral artery perfusion. Four patients are described who developed the anterior tibial compartment syndrome following open heart surgery. It occurred in the limb used for femoral artery perfusion in each patient. In two it was known that the collateral circulation to the limb was also considerably impaired. It is suggested that prolonged limb ischaemia is the major initiating factor. The treatment of these patients is discussed and although one patient was successfully treated conservatively, surgical treatment is advisable. The acute anterior tibial compartment syndrome first described by Vogt (1943) most commonly occurs following lower limb exercise, usually of an intensive nature in a person not used to vigorous activity. The syndrome consists of a dull ache in the anterior part of the lower leg, becoming increasingly painful during or soon after exercise. There is marked tenderness and swelling of the anterior compartment muscles associated with their weakness or paralysis. The dorsalis pedis pulse may or may not be absent, and there may be damage to the deep peroneal nerve. Other less common causes include an embolus in the anterior tibial artery or a fracture of the tibia. This paper describes four patients who developed this syndrome following cardiopulmonary bypass in which the femoral artery had been cannulated.