Foot compartments. How many and it’s clinical relevance

Abstract

IntroductionSeveral authors have assessed the foot with diverse methods, with discrepancies towards the number of compartments. Treatment for foot compartment syndrome is not standardized, but primarily consists of liberating pressure from these, to avoid ischemia, nerve damage, and malformation. Our objective is to synthesize the existing evidence regarding the compartmental anatomy of the footMaterials and methodsA systematic review of all publications evaluating normal foot compartment anatomy was performed using the MEDLINE, Scopus, Web of Science, and EMBASE databases. Data were recorded and analyzed by the reviewers.ResultsAfter filtering results, 10 studies were included in the final analysis. All were performed in cadavers except one. The primary difference was the region studied, half focusing on the plantar region, and the other half evaluating the whole foot. There seems to be an agreement regarding the number of compartments in the plantar region (three major compartments divided by the medial and lateral intermuscular septum), nevertheless, disagreements across authors tend to arise when describing its dorsal section. Only two studies were ranked with an overall low risk of bias using the AQUA checklist. These two agreed on 9 total compartments, however, one included the skin as a 10th compartment, although by definition (space occupied by tissue and bound by fascia or bone) it is not a compartment.ConclusionDiscrepancies in the number of compartments exist between authors. This review provides the best available evidence with an anatomical analysis of data and concludes 9 compartments of the foot. This anatomical description should be taken into account and referenced in clinical reports of foot compartment syndrome treatment to determine the best treatment in a future meta‐analysis based on the same classification.