Lower limb compartment syndrome: course after delayed fasciotomy.
OBJECTIVE
To determine the end result of patients who underwent delayed fasciotomy, i.e., more than 35 hours for an established lower limb compartment syndrome.


METHODS
A retrospective review of patients undergoing delayed treatment for a closed injury of the lower extremity, where fasciotomy should ideally have been performed earlier.


METHODS
Nine fasciotomies in five patients were identified where there was a delay of more than 35 hours after the injury. The average ischemic time was 56 hours (range 35-96 hours).


RESULTS
One patient died of multiorgan failure and septicemia. The remaining four patients required lower limb amputation, because of local infection and septicemia. The one late amputation was performed 6 months after the injury, because the patient was left with a functionless insensate foot. Where recognition of an established compartment syndrome is delayed for more than 8 to 10 hours, we propose that the traditional inevitable fasciotomy be reassessed.
Finkelstein
J A
JA
Division of Orthopaedic Surgery, Sunnybrook Health Science Centre, Toronto, Ontario, Canada.
Hunter
G A
GA
Hu
R W
RW
D000671:Amputation, Surgical; D002423:Cause of Death; D003161:Compartment Syndromes / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000150:complications*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome