LOWER-LIMB COMPARTMENT SYNDROME - COURSE AFTER DELAYED FASCIOTOMY

Objective: To determine the end result of patients who underwent delay ed fasciotomy, i.e,, more than 35 hours for an established lower limb compartment syndrome. Design: A retrospective review of patients under going delayed treatment for a closed injury of the lower extremity, wh ere fasciotomy should ideally have been performed earlier. Materials a nd Methods: Nine fasciotomies in five patients were identified where t here,vas a delay of more than 35 hours after the injury, The average i schemic time was 56 hours (range 35-95 hours). Results: One patient di ed of multiorgan failure and septicemia, The remaining four patients r equired lower limb amputation, because of local. infection and septice mia, The one late amputation was performed 6 months after the injury, because the patient was left with a functionless insensate foot, Where recognition of an established compartment syndrome is delayed for mor e than 8 to 10 hours, we propose that the traditional inevitable fasci otomy be reassessed.