All patients provided written consent and the study was approved by Ethics Committee of Jishuitan Hospital. Our clinical findings showed that sequential treatment of wound management in the early stage and installation of Ilizarov external frame, as well as osteotomy fusion in the late stage of treatment, could effectively restore weight-bearing walking and daily exercises in CS patients.īetween January 2008 and December 2012, 46 patients with lower leg CS and received fasciotomy were admitted to Burn Unit of Beijing Jishuitan Hospital for early wound treatment. We reported the satisfactory recovery of 8 lower leg acute CS patients who were selected from 46 acute CS patients admitted at our hospital between 20 due to their severe muscle necrosis and clubfoot deformity. In this study, we aimed to improve surgical management of acute CS. However, long-term wound management and sequential treatment of complications, particularly severe clubfoot deformity, are seldom reported. Early diagnosis is important to prevent catastrophic complications, including tissue necrosis, claw toe deformity, functional impairment, cavovarus deformities, neuromuscular injury, or joint contracture. Therefore, current studies on CS mostly focus on early diagnosis and treatment. ĭue to severe edema and pain in lower extremity injuries, acute CS is difficult to diagnose which largely relies on the severity of the injury as well as experienced clinical examinations. For patients with recurrent ulcers and severe joint deformities they have to undergo amputation. In addition, damaged and degenerated nerves of leg and foot largely impede patients’ mobility and wound healings. Furthermore, along with the imbalanced muscle strengths of extensors and flexors after surgical removal of the necrotic muscles, eventual fibrosis and retraction of the ischemic muscles result in foot and ankle deformities ranging from claw toes to multiplanar dislocations. Necrotic muscles may trigger systemic inflammatory responses, leading to organ failures and even death. Lower leg CS induces ischemia and necrosis of involved leg muscles and nerves. For instance, the incidence rate of CS after tibia fracture could be as high as 30.4%. Unfortunately, acute CS most often occurs in the anterior compartment of lower legs. The foot and ankle are major weight-bearing structures in daily activities. Traumatic injuries such as fracture and crush-type injury are the main etiologies of CS, while other types of injury, such as ischemia-reperfusion injury after revascularization, posttraumatic arterial and venous thrombosis, tight splint, usages of tourniquet and shock trousers, snake bites and even drug injection, could also induce CS. ConclusionĪcute compartment syndrome and sequential complications could be managed using a number of medical procedures.Īcute compartment syndrome (CS) is a clinical complication that, although uncommon, is seen rather regularly in medical practice. All the patients resumed weight-bearing walking and daily exercises. For patients with serious complications, a number of medical measures, including installation of Ilizarov external frames, arthrodesis, osteotomy fusion, arthroplasty, or tendon lengthening surgery, were performed to achieve satisfactory clinical outcomes.
In the early stage, each patient received systemic support and wound debridement to promote wound healing. ResultsĪll patients had necrotic muscles and nerves, damaged vascular, and severe foot deformities.
#3 compartments of leg full#
The protocols combining early management and the correction of deformities were adjusted in order to attempt to enable full recovery of all patients. MethodsĤ6 patients with acute compartment syndrome were enrolled, including 8 cases with serious complications, between January 2008 and December 2012. Compartment syndrome is most common in lower leg and may lead to permanent injury to the muscle and nerves if left untreated. Acute compartment syndrome occurs when pressure within a compartment increases and affects the function of the muscle and tissues after an injury.
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