Methods employed across studies tended to vary: anatomical dissections, dye infusion, imaging studies, or a combination of these. ![]() Half of them evaluated the plantar section of the foot and the other half evaluated the whole foot. All were performed in cadavers except one. The risk of bias was assessed with the Anatomical Quality Assurance (AQUA) checklist. Three reviewers worked independently and in duplicate to screen all references via a title/abstract and full-text phase. ![]() The search strategy was performed in MEDLINE, Scopus, Web of Science, and EMBASE. ![]() We synthesized the existing evidence regarding the compartmental anatomy of the footĪ systematic review was performed evaluating the anatomy of the foot compartments in non-pathologic specimens. There are discrepancies regarding the anatomy of the foot which complicate standardizing foot compartment treatment. Also, growth impairment can occur after an ischemic contracture in children. Results after reconstruction can be promising but will never lead to complete restoration of initial function. Many treatment options are possible, varying from neurolysis and excision of fibrosed muscles to tendon transfers and even free innervated vascularized muscle transfers with nerve grafting. These contractures can vary tremendously in their severity. If the compartment syndrome is missed it can lead to an ischemic contracture of Volkmann. The technique to release the compartments in both upper as well as lower extremity are described. However, when a compartment syndrome is suspected an immediate release of the involved compartments should be performed to prevent permanent damage. Intercompartmental pressure can be measured in different ways as evidence of a disturbed balance. If this pressure imbalance sustains, muscles and nerves and eventually areas of skin will not survive, classically leading to pain, pallor, pulselessness, paresthesia, and paralysis (also called “the five Ps”) in the involved extremity. Basically they are areas of muscles, nerves, and vessels surrounded by bone and tight fascia not yielding to an increased pressure, for instance after trauma when edema occurs. The anatomy of the compartments in the forearm and hand as well as in the lower leg and foot are described. The extremities are susceptible to compartment syndrome if the balance between inflow and outflow in the compartments is disturbed, i.e., the relation between hydrostatic pressure and interstitial fluid pressure. Thorough inspection within anatomic areas or generous release of the muscular origin along the metacarpal at the time of fasciotomy is suggested to ensure complete inspection. ![]() Subcompartmentalization of the enclosed myofascial spaces of the hand should be anticipated in cases requiring fasciotomy. The dorsal and palmar interosseous muscles were discrete compartments within the second interosseous compartment in 48% of the hands, within the third interosseous compartment in 67%, and within the fourth interosseous compartment in 33%. The interosseous compartments demonstrated significant variability. The adductor pollicis and first dorsal interosseous muscles were discrete compartments in 71% of the hands. In 76% of the specimens, the hypothenar space demonstrated at least 2 compartments. The results showed the thenar space to comprise 2 or more discrete compartments in 52% of the hands. Data were collected from the prepared cross-sections of each specimen. To determine the nature and number of enclosed myofascial spaces in the hand, an anatomic study that included 21 cadaver hands was conducted using a gelatin injection method.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |