Stručni rad
ANTERIOR COMPARTMENT SYNDROME OF THE LEG: A CASE REPORT
Davor Grdošić
Ivica Lucijanić
Tatjana Ćapin
Marko Pećina
Sažetak
Anterior compartment syndrome of the leg may appear in an acute form characterized by a rapid development of ischemic changes, especially in the anterior tibial muscle, which is why it is called “syndrome m. tibialis anteriora” or “tibialis anterior syndrome,” or in a chronic form which develops gradually and is considered an overuse injury and can lead to the condition known as shin splints or “runner's leg.” We present a case involving an acute form of anterior compartment syndrome in a recreational sportsman, a postman who often had to climb stairs carrying heavy packages prior to the onset of the syndrome. The patient, 40 years of age, checked into the orthopedics clinic complaining of swelling and unbearable pain in the anterior part of the left lower leg, He was immediately diagnosed with an early stage of acute anterior compartment syndrome with arterial circulation still intact and no neurological incidents. Routine laboratory tests showed normal results except the creatine kinase value, which was 1124 U/L (the upper limit of the reference range is 177). He was processed for an urgent fasciotomy, a decompression of the anterior compartment, which was performed as an open procedure. During the surgery we found ischemic muscle changes, but no signs of muscle tissue necrosis. After the fasciotomy the skin was sutured using adaptive stitches. Postoperatively the patient was well, and control laboratory tests revealed creatine kinase values of 422 U/L on the second day following the surgery and 112 U/L, or normal, on the fifth day after the surgery. After the scar healed nicely and the patient completed physical therapy, he went back to work and resumed his athletic activities five weeks after starting the treatment. With regard to anterior compartment syndrome, the condition should be suspected and diagnosed as early as possible. After confirmation of the diagnosis, an urgent fasciotomy should be performed as a first-line treatment option. The presence of elevated creatine kinase levels may be used, at least in part, to confirm a suspected acute form of the syndrome, while changes in creatine kinase levels may be used to help monitor and evaluate a patient’s postoperative progress.
Ključne riječi
anterior exertional compartment syndrome; clinical features; diagnosis; creatin-kinase level; fasciotomy
Hrčak ID:
20135
URI
Datum izdavanja:
28.12.2007.
Posjeta: 12.608 *