title: Acute compartment syndrome following fibula flap harvest for mandibular reconstruction.
abstract: Donor site morbidity for free fibula osteofasciocutaneous flaps has rarely been reported in the literature. We report on a case of acute compartment syndrome (ACS) in a 22-year-old male, following fibula flap harvest for mandibular reconstruction and arising after post-ischemic reperfusion damage. Dissection during this patient's surgery was unusually difficult. The skin defect was covered with a loose dressing while waiting for secondary grafting. Intracompartmental pressures measured by the Wick catheter technique confirmed the diagnosis of ACS. ACS is an unexpected complication after fibula flap harvest since the three compartments of the leg are opened during surgery. Only four cases of ACS have been reported in the literature. Analysis of this serious complication might lead to changes in the routine use of the pneumatic tourniquet in some selected cases. New automatic tourniquet systems might also be advantageous in such cases.
authors.affiliation: AP-HP, Pitié-Salpêtrière University Hospital, University of Paris 6-Pierre et Marie Curie, Department of Maxillo-facial Surgery, Paris, France. sihamkerrary@hotmail.fr
authors.forename: Siham
authors.initials: S
authors.lastname: Kerrary
authors.forename: Thomas
authors.initials: T
authors.lastname: Schouman
authors.forename: Amanda
authors.initials: A
authors.lastname: Cox
authors.forename: Chloe
authors.initials: C
authors.lastname: Bertolus
authors.forename: Guillaume
authors.initials: G
authors.lastname: Febrer
authors.forename: Jacques Charles
authors.initials: JC
authors.lastname: Bertrand
mesh_terms: D000208:Acute Disease; D003161:Compartment Syndromes / Q000209:etiology*; D005360:Fibula / Q000601:surgery*; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008339:Mandibular Neoplasms / Q000534:rehabilitation / Q000601:surgery; D012516:Osteosarcoma / Q000534:rehabilitation / Q000601:surgery; D015427:Reperfusion Injury / Q000601:surgery*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D014111:Tourniquets / Q000009:adverse effects*; D055815:Young Adult