A 40-year-old pedestrian is hit by a vehicle and sustains a fracture of the proximal tibia. After 12 hours, he complains of severe calf pain worsening on dorsiflexion of the foot, with paraesthesia of the dorsum of the foot. Compartment pressure is 42 mmHg. The most likely affected compartment is:

• A Posterior superficial compartment
• B Posterior deep compartment
• C Anterior compartment ✓
• D Lateral compartment

Explanation

The anterior compartment of the leg is the most commonly affected in compartment syndrome of the leg, particularly after tibial fractures. Pain on passive dorsiflexion of the foot (stretching the tibialis anterior and toe extensors) combined with paraesthesia over the dorsum of the foot (first web space — deep peroneal nerve) points to anterior compartment syndrome. A compartment pressure above 30 mmHg or within 30 mmHg of diastolic pressure mandates immediate four-compartment fasciotomy.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.