Exertional Compartment Syndromes

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Exertional Compartment Syndromes (ECS)

Due to increased pressure in compartments of leg.
Intense exercise or trauma  expansion of muscle  becomes compressed in muscle sheath  may be problematic if sheath is tight  intracompartmental pressure increase  if neurovascular structures are compressed  medical emergency (acute compartment syndrome).

Chronic compartment syndrome:
Chronic form is exercise induced that recurs with exercise, but symptoms are relieved with rest (not a medical emergency). Pathogenesis is an impairment in tissue perfusion. Aetiology is unclear – may be due to a decrease in volume of the muscle compartment (tight and/or thick fascia); increased content of the compartment (muscle hypertrophy or swelling).

Arteriovenous gradient theory:
Increase in tissue pressure  increase in local venous pressure  reduction in local AV gradient  reduced local blood flow and tissue oxygenation  tissue viability affected.

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