Indication of Surgical Decompression in Lower Limbs Compartment Syndrome

Abstract

When compartment syndrome is treated with the wrong primary care, necrosis of the tissue occurs, and amputation may be inevitable.
We examined lower limb compartment syndrome and the indication of surgical decompression in nine patients. Three cases had proximal tibial fracture, three cases were soft tissure injury, and three cases were postoperation of circulation reconstructive surgery for acute arterial oblicanse.
We measured the intracompartmental pressure at emergency in all cases and performed decompressive fasciotomy in eight cases.
Deep infection and necrosis occurred in one case which needed skin graft and foot arthrodesis.
We were able to leave the diseased limb in all cases.
Although the preoperative intracompartmental pressures was 30-120 mmHg, we determined the indication of surgical decompression from strong pain and swelling.
Muscle pressure measurement by A-line is very useful and can be performed during operation. Surgical decompression is added or extended aiming at less than 20 mmHg.