Intramuscular pressure, muscle blood flow, and skeletal muscle metabolism in chronic anterior tibial compartment syndrome.

One hundred eight patients with lower leg pain of unknown cause underwent intramuscular pressure measurements by the wick technique. Fifteen patients (14%) were found to have a chronic anterior tibial compartment syndrome. In these patients the intramuscular pressure was significantly increased at rest and during and after exercise as compared with normal subjects. The pressure increase after exercise was long-lasting (40 minutes). Biopsies of the anterior tibial muscles showed increased water content, which may explain the elevated pressures. Muscle blood flow during exercise as measured by the xenon-133 clearance technique was decreased, and muscle lactate concentration was increased in the anterior tibial muscles. Fasciotomy relieved pain and normalized intramuscular pressure, muscle blood flow, and skeletal muscle metabolism.