The effect of ankle position on intracompartmental pressures of the leg

Objectives: We investigated differences in the intracom¬partmental pressures (ICP) of the leg in relation to various positions of the ankle joint in patients with chronic exer- tional compartment syndrome (CECS). Methods: The study included 16 patients (10 males, 6 fe¬males; mean age 30±9 years, range 16 to 48 years) actively involved in various sports. Intracompartmental pressures were monitored with the use of slit catheters connected to a pressure transducer in 28 anterior and 14 deep posterior compartments before and after exercise during the following positions of the ankle joint: relaxed-resting, passive plantar flexion, neutral, and passive dorsiflexion. Alterations in ICP were assessed with reference to that measured in the relaxed- resting position of the ankle. Results: Significant increases in ICP were observed in both anterior and deep posterior compartments during dor- siflexion of the ankle, being 9.1±10.6 mmHg (p=0.0001) and 8±10.3 mmHg (p=0.001) in the anterior compartment, and 6.4±4.4 mmHg (p=0.0001) and 7.2±4.3 mmHg (p=0.001) in the deep posterior compartment before and after exer¬cise, respectively. No significant increases were found in other positions of the ankle (p>0.05). While the lowest values of ICP were noted in the relaxed-resting position, plantar flexion of the ankle was associated with decreased ICP pressures. Conclusion: Dorsiflexion of the ankle increases ICP sig¬nificantly in both anterior and deep posterior compart¬ments. The results of this study may have clinical implica¬tions for the conservative management of both CECS and tibial fractures.