Which passive movement causes pain in deep posterior compament syndrome ?
Passive stretching of the muscles produce pain in compament syndrome and hence, dorsiflexion of foot (a) causes pain. Posterior compament of leg is concerned with plantar flexion of foot, and is supplied by the tibial nerve and posterior tibial vessels. Compament syndrome is caused by increased pressure in an enclosed space that leads to compromise of circulation and function of tissues in that space. a. There is elevation of interstitial pressure in closed fascial compament that results in microvascular compromise. b. As duration & magnitude of interstitial pressure increase, myoneural function is impaired & necrosis of soft tissues eventually develops. Pain with passive stretching is the most sensitive early sign of compament syndrome. a. Patient will usually hold injured pa in a position of plantar-flexion to maximally relax the fascia/muscles and reduce pain. b. For e.g., Clawing of the toes is a common sequela of post-traumatic compament syndrome within the deep posterior compament following a distal third tibia fracture. Fasciotomy is one of the definitive treatments of the syndrome. Ref - CSDT 12th e p1123
Foot abduction
Dorsi flexion of foot
Plantar flexion of foot
Foot adduction
Lower limb