Compartment Syndrome of the Lower Leg After Surgery in the Modified Lithotomy Position: Report of Seven Cases

Abstract

Acute compartment syndrome can be prevented if adequate measures are taken, but after lengthy surgery, maximum alertness for emerging acute compartment syndrome remains indicated. Early diagnosis and treatment by four-compartment fasciotomy is still the only way to prevent irreversible damage.

Three-limb compartment syndrome and rhabdomyolysis after robotic cystoprostatectomy

“…This relatively new technology presents challenges both to the operating urologist and anesthesiologist. The steep Trendelenburg position combined with the lithotomy position during major portions of the procedure are known risk factors for the development of WLCS [7][8][9][10][11][12]. The lithotomy position is necessary to position the robot between the lower extremities, and the Trendelenburg position aids in operative exposure of pelvic organs.…”

A 20‐year‐old man with right leg pain following orofacial surgery

“…Potential risk factors for the development of atraumatic compartment syndrome after surgery are the length of the procedure (Ͼ5 hours), decreased perfusion of the lower leg because of either Trendelenberg or lithotomy positioning during surgery, and inadvertent external compression of the lower leg (e.g., through the malfunction of pneumatic boot compression devices) (5). Fluid shifts following prolonged periods of immobility are also postulated to contribute to the development of compartment syndromes.…”

Acute compartment syndrome: reducing the risk

“…Furthermore, the lithotomy compartment syndromes seem to have a slow and insidious onset and the diagnosis of a compartment syndrome may be very difficult, especially when the patient's perception of pain is altered by regional anaesthesia. 9 Compartment syndrome and vascular problems are also well-recognized complications of total knee replacement. Unfortunately, an inability to dorsiflex the foot may be wrongly attributed to an epidural.…”