anterior compartment syndrome

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A potentially dangerous overuse injury of the lower leg characterized by feelings of pressure or severe pain and burning in the shins during exercise. The symptoms abate during rest. Its exact cause is uncertain, but it probably results from muscle hypertrophy. The anterior tibial compartment is bounded medially by the tibia, laterally by the fibula, posteriorly by the posterior interosseous membrane, and anteriorly by the deep fascia. All of these are relatively inflexible structures. During exercise, increased blood flow raises the pressure in the compartment, pressing muscles and other internal structures against the compartment walls; this can lead to ischaemia. Anterior compartment syndrome may require radical treatment: cessation of activity, elevation, compression (bandages and massage), and anti-inflammatory and diuretic drugs to increase urine flow and reduce swelling. Unless the condition is managed properly, it can deteriorate and become so severe that pressure in the compartment damages nerves permanently. Surgery may be necessary to divide muscle fascia and give the enlarged muscle more space. Surgery may also be required in cases of anterior compartment syndrome resulting from heavy bleeding inside the muscles caused by a traumatic accident (e.g. a fracture or when the leg is severely bruised after a kick).

Subjects: Sports and Exercise Medicine.

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