[Acute compartment syndrome and complex trauma of the foot]

Acute posttraumatic compartment syndrome of the foot is generally the consequence of a severe foot trauma. If the compartment syndrome is left unrecognized and untreated foot deformities and a variety of different functional impairments will follow, making secondary surgical interventions necessary. At present 9 or 10 clinically relevant compartments can be defined anatomically. The early diagnosis particularly in the unconscious patient is based essentially on measurement of the tissue pressure in the corresponding compartments. An effective compartment release depending on the extent of injury and involvement of the specific compartments needs knowledge of three different approaches. A complex foot trauma represents a clearly defined term (Zwipp score or zones-of-injury concept) which still has a quite ominous prognosis if it is not treated according to a stringent regime based on a profound expertise in this quite variable injury entity. An interdisciplinary approach is often deemed to be essential for a reasonable outcome. None of the accepted scores have proven to be useful for primary decision-making of amputation or for the assessment of the long-term prognosis.