Hakeem Nicks of the New York Giants Undergoes Surgery
New York Giants, and former University of North Carolina standout receiver Hakeem Nicks, underwent faciotomy surgery on his right leg today for compartment syndrome. Will he be able to return this season?
The leg, from the knee to the ankle, has four compartments. Each of these four compartments is like “rooms”. Muscles, tendons, nerves, and blood vessels travel in each of these “rooms”. Any injury to one of the compartments can cause swelling and bleeding into the “room”. The walls of the room can only expand so much. After that, the pressure in the room continues to increase. As the compartment pressure increases above the blood pressure of the body, the arteries can collapse and the blood supply to the compartment can stop. If this happens, the muscles, tendons, nerves, veins, and arteries can die.
The most common causes of compartment syndrome of the leg are muscle bruises, over training, steroids, crush injuries, breaks in the bone, and tight wraps on the leg.
People who have compartment syndrome typically will complain of 5P’s: pain out of proportion to the injury, pallor, paresthesia (pins and needles), paralysis, loss of pulse (least reliable). At times, a 6th P is includes: poikilothermia (failure to regulate heat).
The treatment for an acute compartment syndrome is to do a compartment release (or opening the room). If this is done within six hours of the symptoms, the damage to the muscles, tendons, nerves, and blood vessels is usually reversible. The surgery can be performed with open techniques, or through minimally invasive techniques.
WHEN TO SEEK MEDICAL CARE
If you suspect that you have a compartment syndrome, you should seek medical attention immediately. A good physical exam, x-rays, and perhaps a compartment pressure monitor may be needed to evaluate the compartment pressures.
RETURN TO ACTIVITIES/OUTCOMES
Most athletes with this injury are out from competitive plays for at least 4 to 6 weeks. Extensive rehabilitation is needed to regain the strength of the muscles in the compartment.
Hakeem Nicks is an impact player for the Giants. We hope to see him in the post-season.
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