As we all know, there are many different foot and ankle injuries that may befall an individual. However, some of the most life altering ones are crushing injuries. They, by their very nature, have the ability to cause widespread and sometimes irreversible damage to the foot and ankle. That’s why many Ballwin podiatrists believe in examining patients with broken ankles and crushed feet for signs and symptoms typically associated with compartment syndrome.
Compartment syndrome is primarily associated with crushing injuries that involve osseofascial compartments. Osseofascial compartments are found in a human’s limbs. They are actually closed segments within the limbs that are defined by fascia and bone. The foot alone has at least six such areas. They are known as the calcaneal, lateral, interosseous, superficial, adductor and medial compartments. The ankle is also affected by the four compartments that exist in the lower leg. They are known as superficial posterior, anterior, lateral and deep posterior compartments.
Within the defined borders mentioned above are muscles, soft tissue, tendons, blood vessels and nerves. As such, the areas have their own interstitial pressure level, which may be altered by crushing injuries and certain diseases. Once that pressure level is altered, it may disrupt the normal flow of blood. That, in turn, may cause tissue death, nerve damage, skin tightness and the formation of foot and ankle ulcers.
To determine whether or not a person has compartment syndrome, podiatrists may order an interstitial pressure test or CT arthrography and conduct a physical exam. If the interstitial pressure in the broken ankle or foot needs to be adjusted, a podiatrist may recommend that the patient undergo a fasciotomy.
It is a complicated, surgical procedure designed to immediately reduce the pressure in the affected area or areas. Afterward, the patient must typically restrict his or her movements for a minimum of five days and then potentially undergo a second surgical procedure to permanently close the open incisions (e.g. skin grafts). Once the second surgery has been completed, the patient may be faced with additional downtime.
In other instances, podiatrists may suggest that the patients with broken ankles try bed rest, foot elevation, anti-inflammatory medications, pneumatic intermittent impulse compression devices and splinting instead. It really all hinges upon how severe the change in pressure is and how long it has been left unchecked. To learn more about compartment syndrome and the treatments involved, please contact your local podiatry office.