COMPARTMENT SYNDROME OF THE FOOT IN CHILDREN

Compartment syndrome of the foot following trauma is well known in adu lts but has not been discussed frequently in texts on pediatric trauma . In the current study, seven children and teenagers were identified a s having had compartment syndrome of the foot during a five-year perio d. The average age at the time of the diagnosis was ten years (range, four to sixteen years). The cause of the compartment syndrome was a cr ush injury in six patients and a motor-vehicle accident in one. All pa tients had swelling and pain with passive motion, but none had neurova scular deficits. Only the two oldest children had an osseous injury th at necessitated open reduction and internal fixation, but all had elev ated compartment pressures ranging from thirty-eight to fifty-five mil limeters of mercury (5.07 to 7.33 kilopascals). All seven patients had fasciotomies of the nine compartments of the foot, and the skin was c losed primarily within five days after the operation. No patient had c omplications or needed a skin graft. All patients had a good or excell ent result after an average duration of follow-up of forty-one months (range, twenty-three to fifty-three months). Orthopaedists managing ch ildren who have a traumatic injury of the foot, especially a crush inj ury, should have a high index of suspicion for compartment syndrome, e ven in the absence of severe fracture.