Author(s): Nerlich M, Dziadzka S, Schmidt U
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Abstract An analysis of 134 surgically treated compartment syndromes of the lower leg was combined with a long-term follow-up concerning late sequelae. Direct trauma including simple closed as well as severely comminuted open fractures of the tibia and fibula were predisposing factors for the development of a compartment syndrome. Clinical symptoms led to the correct diagnosis, supported by intracompartmental pressure measurements. A unilateral parafibular dermatofasciotomy involving opening all four compartments was the therapy of choice. Fifty-nine per cent of the patients had no late sequelae at the 4.2 year follow-up. 12\% poor results were characterized by loss of function and neurological deficits. This group included 8 amputations above the knee due to ischemic/infectious muscle necrosis. The time interval between trauma and operation was found to be the main contributing factor to the poor results, with a delay of 23 h due to secondary referral of the patients. Fasciotomy per se showed only minimal morbidity and is strongly recommended as an emergency procedure.
This article was published in Unfallchirurg
and referenced in Orthopedic & Muscular System: Current Research