[Good results of fasciotomy in chronic compartment syndrome of the lower leg].
OBJECTIVE
To assess the results of fasciotomy in patients with a chronic compartmental syndrome.


METHODS
Retrospective study.


METHODS
Department of Surgery, Central Military Hospital, Utrecht, the Netherlands.


METHODS
Closed fasciotomy was performed in 81 patients (151 compartments) after standardized measurement of the pressure of the symptomatic compartment during exercise. The anterior compartment was affected 149 times and the lateral compartment twice. The pressure reading was repeated at least 3 months after the operation. All operated patients 6 months postoperatively were sent a written questionnaire inquiring about the results of the operation.


RESULTS
Postoperative complications included a neurinoma (3 times) and a seroma (once). The mean postoperative intramuscular pressures were lower than the preoperative ones: the pressure at rest fell from 22.1 to 14.0 mm Hg (p < 0.05), the exercise pressure from 57.5 to 25.4 mm Hg (p < 0.01) and the relaxation pressure from 34.4 to 25.2 mm Hg (p < 0.05). Ten patients had an unchanged increased pressure after the operation, for which a second fasciotomy was performed 4 times. Attenuation of symptoms was reported by 59 patients (76%). Nine patients with poor results had already had a combination with some other hyperpressure injury before the operation.


CONCLUSIONS
Closed fasciotomy in a demonstrated chronic compartmental syndrome in most cases gave good results, viz. attenuation of symptoms and a decrease of the intramuscular pressure, especially after exercise.
Verleisdonk
E J
EJ
Academisch Ziekenhuis/Centraal Militair Hospitaal, afd. Heelkunde, Utrecht.
van den Helder
C J
CJ
Hoogendoorn
H A
HA
van der Werken
C
C
D000293:Adolescent; D000328:Adult; D000868:Anterior Compartment Syndrome / Q000503:physiopathology / Q000601:surgery*; D002908:Chronic Disease; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011312:Pressure; D012008:Recurrence; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome