J Korean Fract Soc.  2015 Oct;28(4):223-229. 10.12671/jkfs.2015.28.4.223.

Clinical Outcomes of Fasciotomy for Acute Compartment Syndrome

• Park JY
• Kim YC
• Kim JW

• KMID: 2070348
• DOI: http://doi.org/10.12671/jkfs.2015.28.4.223

Abstract

PURPOSE
The purpose of this study is to evaluate clinical outcomes and complications after fasciotomy in acute compartment syndrome.
MATERIALS AND METHODS
Seventeen cases diagnosed as compartment syndrome and underwent fasciotomy from January 2011 to February 2015 were evaluated retrospectively. We investigated the causes and regions of acute compartment syndrome, the methods of wound management, the necessity of skin graft, and the complications including amputation and infection.
RESULTS
According to the causes of acute compartment syndrome, there were 7 fractures, 1 traumatic hematoma, 6 reperfusion injury, and 3 rhabdomyolysis. The regions of acute compartment syndrome were 3 cases of thigh, 10 cases of leg, and 3 cases of foot. One case had acute compartment syndrome involving thigh, leg, and foot. Of 17 cases, 3 cases died due to reperfusion injury and one case with severe necrosis of soft tissues underwent amputation. Among the 13 cases excluding 4 cases with death or amputation, 3 cases underwent split thickness skin graft. Shoelace technique and/or vacuum-assisted closure (VAC) was used for 9 cases, and wound closure without skin graft was achieved in all except one case, while 2 cases required skin graft among 4 cases without shoelace technique or VAC. There were 2 cases of infection.
CONCLUSION
Acute compartment syndrome caused by reperfusion injury had poor outcomes. Shoelace technique and/or VAC were useful for management of wound after fasciotomy.

Keyword

Acute compartment syndrome; Fasciotomy; Wound management; Complications

MeSH Terms

Amputation
Compartment Syndromes*
Foot
Hematoma
Leg
Necrosis
Negative-Pressure Wound Therapy
Reperfusion Injury
Retrospective Studies
Rhabdomyolysis
Skin
Thigh
Transplants
Wounds and Injuries

Figure

• 

  Fig. 1 (A) A 41-year-old male had both a tibia shaft fracture and severe swelling on the left leg with pain. Emergency fasciotomy was performed with a double incision on lateral (B) and medial (C). A photograph at 4 days after injury shows that shoelace technique and negative pressure wound dressing was applied on lateral (D) and medial (E). Progressive wound closure was performed using shoelace technique and negative pressure wound dressing on the lateral side (F) and medial side (G). (H, I) At 16 days after injury, complete wound closure was possible without skin graft.

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