2020 Volume 66 Issue 3 Pages 162-166
Compartment syndrome developing after sagittal split osteotomy (SSRO) is rare, but once it occurs, it can have fatal complications because of rhabdomyolysis and acute renal dysfunction. Here, we report a case of acute lower leg compartment syndrome that occurred after SSRO. The patient was a 17-year-old girl. She underwent bilateral SSRO via the Obwegeser technique to correct mandibular protrusion. Postoperatively, she felt severe pain in her left lower leg, associated with redness and diffuse swelling. The blood creatinine kinase (CK) level increased to 2,674 U/L. Enhanced computed tomography revealed swelling of the left lower leg with a low absorption area of contrast agent. Compartmental pressure measurements on the left leg were as follows: anterior, 70 mmHg; lateral, 72 mmHg; superficial posterior, 25 mmHg; and deep posterior, 70 mmHg. A clinical diagnosis of acute compartment syndrome was made. She underwent a 4-compartment fasciotomy of her left leg. Postoperatively, she underwent intensive care to prevent acute renal dysfunction. As the blood CK level decreased, she was discharged on the 26th postoperative day. One year after the operation, there is no relapse and the clinical course is good. There is no loss of sensation in the left lower leg, and the ability to do light running recovered.
