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Trauma to the Leg

Learn about compartment syndrome pathophysiology, neurovasculature focus, and treatment guided by anatomical landmarks in lower leg trauma cases. Explore the anterior compartment, major arteries, and nerves involved. Helpful resources and key points provided.

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Trauma to the Leg

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  1. Trauma to the Leg Gazi Rashid, M4 grashid@emory.edu Dec 12th 2018 ASP Clinical Anatomy

  2. Objectives Use a common trauma injury case to… • Understand the basic pathophysiology of compartment syndrome • Focus on the neurovasculature of a single compartment • Walk through the treatment guided by anatomical landmarks

  3. Compartments in the Lower Leg 1 3 2 4 Med Lat R

  4. A common trauma patient

  5. ABCDE

  6. Med Lat

  7. Whew… • Went through ABCDEs • Arteries and veins intact • Broken tibia • Called Ortho

  8. What now?

  9. Compartment Syndrome

  10. Compartment Syndrome

  11. Compartments in the Lower Leg Med Lat Med Lat R

  12. What’s the treatment?

  13. Fasciotomy

  14. Objectives Use a common trauma injury case to… • Understand the basic pathophysiology of compartment syndrome • Focus on the neurovasculature of the anterior compartment • Walk through the treatment guided by anatomical landmarks

  15. Review the Qs • What’s the major artery passing through the anterior compartment that eventually becomes the dorsalidpedis? • The Common Peroneal nerve gives off what branch in the Lateral compartment and what branch in the Anterior compartment? • CS of the anterior compartment presents as numbness or tingling where? • Foot drop occurs with damage to the deep peroneal because which muscle is affected?

  16. Links • Acute Compartment Syndrome of the Lower Leg: A Review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4970751/ • Lower extremity compartment syndrome: https://tsaco.bmj.com/content/2/1/e000094 • Two Incision Four Compartment Fasciotomy: https://www.youtube.com/watch?v=-1NDJkFH1vM&ab_channel=operationgivingback

  17. Things to Know • Vasculature • Anterior tibial artery is the blood supply for this compartment…terminal branch of popliteal artery…passes anteriorly through gap in superior part of interosseous membrane, at malleoli  Becomes dorsal artery of foot • The posterior tibial artery and its biggest branch the fibular artery supply the posterior compartment. • Know nerves • Deep peroneal - Extends in to foot to supply extensor digitorum brevis and extensor hallicus brevis and skin b/ 1st and 2nd toes • Goes to tibialis anterior  dorsiflexes  foot drop

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