LATE MANAGEMENT OF COMPARTMENT SYNDROMES

Four patients have presented secondarily to this unit in recent years with rhabdomyolysis following prolonged compartment syndromes conseque nt upon drug overdoses or severe injury. Multiple complications arose due to the severe nature of the compartment syndrome itself and also i ts late and sometimes incomplete initial treatment. In two, cases out of four a secondary amputation was required. Our experience with these cases demonstrates the importance of repeat examination under anaesth etic of the affected limbs following fasciotomy, even if apparently he althy granulation tissue is forming, and the value of persistent oedem a and elevated creatine phosphokinase levels as markers of continued p athology. Observation of these factors may enable amputations and prol onged nerve palsies to be avoided in future patients.