Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2] ;

Overview[edit | edit source]

Compartment syndrome can be found wherever a compartment is present. Possible sites include the lower leg, forearm, wrist, and hand ^{[1][1][2][3][4][5][6] [7][8][9]}.

Anatomy[edit | edit source]

Lower leg[edit | edit source]

The lower leg is divided into 4 compartments.

• Anterior
• Lateral
• Superficial posterior
• Deep posterior
• Tibialis posterior

Anterior compartment[edit | edit source]

Muscles in the anterior compartment are :

• Tibialis anterior
• Extensor digitorum longus
• Extensor hallucis longus
• Peroneus tertius

The anterior compartment borders are as follows:[edit | edit source]

• Tibia
• Fibula
• Interosseous membrane
• Anterior intermuscular septum

Lateral compartment[edit | edit source]

The lateral compartment includes the peroneus longus and brevis and the common peroneal nerve superficial branch lies Within the compartment:

• Anterior intermuscular septum
• Fibula
• Posterior intermuscular septum
• Deep fascia

Superficial posterior compartment[edit | edit source]

The superficial posterior compartment include: the gastrocnemius, soleus, and plantaris. It is surrounded by the deep fascia of the leg.

Deep posterior compartment[edit | edit source]

The muscles within the deep posterior compartment are as follows:

• Flexor digitorum longus
• Flexor hallucis longus
• Popliteus
• Tibialis posterior

The borders of the deep posterior compartment are as follows:

• Tibia
• Fibula
• Deep transverse fascia
• Interosseous membrane

Tibialis posteriorcompartment[edit | edit source]

The tibialis posterior compartment is a more recently described subdivision of the deep posterior compartment. It consists of the tibialis posterior, which has been shown to have its own fascial layer.

Forearm[edit | edit source]

Four interconnected compartments of the forearm are recognized, as follows:

• Superficial volar (flexor)
• Deep volar
• Dorsal (extensor) compartment
• Compartment containing the mobile wad of Henry

The deep volar compartment contains the flexor digitorum profundus, flexor pollicis longus, and pronator quadratus muscles and tendons. The mobile wad of Henry comprises the brachioradialis, extensor carpi radialis brevis (ECRB), and extensor carpi radialis longus muscles and tendons.

Elevated pressures most commonly affect the volar compartments, but the dorsal and mobile wad compartments may also be involved, alone or in addition to the volar compartments. It is usually difficult to clinically differentiate isolated or combined involvement of the deep and superficial volar compartments.

Wrist[edit | edit source]

In the wrist, most of the soft tissues are bound within rigid compartments for example the volar wrist tendons, for the most part, are tightly constrained within the carpal tunnel (thumb and finger long flexor tendons), except for the flexor carpi radialis, flexor carpi ulnaris, and palmaris longus tendons, which are in separate compartments. The dorsal compartments are primarily channels for tendons and are rarely afflicted by compartment syndrome.

The dorsal extensor tendons pass under an extensor retinaculum and are divided into 6 compartments, as follows:

• Radial wrist abductor (abductor pollicis longus tendon) and thumb extensor (extensor pollicis brevis tendon) dorsal to the trapezium bone
• Radial wrist extensors (extensor carpi radialis longus and ECRB tendons) dorsal and radial to the trapezoid bone
• Extensor pollicis longus tendon
• Common finger extensors (extensor digitorum communis [EDC] tendon) dorsal to the capitotrapezoid articulation
• Extensor digiti minimi tendon to the fifth digit
• Ulnar wrist extensor (extensor carpi ulnaris tendon) in a groove adjacent to the ulnar styloid

Hand[edit | edit source]

The hand has 10 compartments:

• Dorsal interossei (4 compartments)
• Palmar interossei (3 compartments)
• Adductor pollicis compartment
• Thenar compartment
• Hypothenar compartment

References[edit | edit source]