title: A prospective study of surgical outcomes and quality of life in severe foot trauma and associated compartment syndrome after fasciotomy.
abstract: The purpose of the present prospective study was to analyze the predictors of outcome and review the quality of life of patients who underwent emergency fasciotomy for foot compartment syndrome after blunt trauma. A total of 14 patients were identified and followed for an average of 24 (range 14 to 33) months. The mean interval from initial presentation to decompressive fasciotomy was 5.8 (range 3 to 11) hours. The follow-up data from our patients revealed satisfactory functional and quality of life outcomes, with 11 of 14 (78.6%) able to return to work. Two (14.3%) patients developed claw-toe deformities and 3 (21.4%) patients had sensory deficits directly attributed to compartment syndrome. Finally, 4 (28.6%) patients required modified shoes or shoe inserts for comfortable ambulation. Our findings suggest that earlier fasciotomy results in better quality of life scores, American Orthopaedic Foot and Ankle Society scale scores, and visual analog scale pain scores and a greater likelihood of being able to wear all shoes comfortably, ambulate independently, and return to work. A shorter interval to fasciotomy, younger age, the absence of bony injury, the absence of other concomitant injuries, and a low velocity crush injury all tended to be predictors of good outcomes at the final review.
authors.affiliation: Senior Resident, Department of Orthopaedic Surgery, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, National University Health System, Republic of Singapore. Electronic address: fucai_han@nuhs.edu.sg.
authors.forename: Fucai
authors.initials: F
authors.lastname: Han
authors.affiliation: Senior Resident, Department of Orthopaedic Surgery, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, National University Health System, Republic of Singapore.
authors.forename: Zubin J
authors.initials: ZJ
authors.lastname: Daruwalla
authors.affiliation: Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore.
authors.forename: Liang
authors.initials: L
authors.lastname: Shen
authors.affiliation: Professor Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore; Senior Consultant, Department of Orthopaedic Surgery, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, National University Health System, Republic of Singapore.
authors.forename: V Prem
authors.initials: VP
authors.lastname: Kumar
mesh_terms: D000328:Adult; D003161:Compartment Syndromes / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019299:Decompression, Surgical; D000071938:Fasciotomy; D005260:Female; D018409:Foot Injuries / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000601:surgery*; D055815:Young Adult
keywords: blunt trauma; early fasciotomy; foot compartment syndrome; predictors of outcomes; quality of life