Compartment syndrome and fasciotomy in vascular surgery. A review of 57 cases

Abstract

Compartment syndrome is usually related to acute ischaemia and rarely following elective vascular surgery. Subcutaneous fasciotomy does not always ensure sufficient decompression of all four lower leg compartments. Complications related to fasciotomy are rare.

Acute Limb Compartment Syndrome: A Review

“…Therefore, pain out of proportion to that expected with the injury should provoke a strong suspicion of LCS. 42 An important early finding suggesting need for referral is pain on passive stretching or a compression of ischemic muscles in the compartment. 34 Paresthesia results from a disordered cell membrane function in nerves running through the affected compartment, which may be an early sign of impending nerve ischemia.…”

Compartment Syndrome of the Lower Extremity

“…He advocated long skin incisions only if there was massive soft tissue swelling, paralysis or borderline function of muscles, or if muscle necrosis was encountered. Jensen and Sandermann [114] compared subcutaneous and open fasciotomy. Five of 39 limbs that had subcutaneous fasciotomy still showed signs of compartment syndrome and all five patients required reoperation with long skin incisions.…”

“…Compared to the doubleincision technique, single incision fasciotomy is less traumatising and gives better cosmetic results. Furthermore it leaves the long saphenous vein unexposed, which can be advantageous if later reconstructive vascular surgery is required [113,114]. A disadvantage of the single incision approach is that the deep posterior compartment is difficult to access and decompress.…”

Lower Limb Acute Compartment Syndrome After Colorectal Surgery in Prolonged Lithotomy Position

“…48 Even with prompt and adequate surgical decompression, full restoration of muscle and nerve function is not guaranteed, and in one-third of cases the final outcome is a disabled leg, in up to one-quarter amputation is required, and in up to 15 percent death will occur during hospital admission. 41,49 …”