Issues in management of fractures complicated by compartment syndrome

Abstract

Introduction: Compartment syndrome has been identified as an acute devastating orthopaedic emergency and early fasciotomy is the only way to prevent any complications This retrospective study proposes to analyse the issues in management of fractures complicated by compartment syndrome occurring pre-operatively and post-operatively. Aim: To study the issues involved in the rationale for deciding the method of fracture stabilization following fasciotomy. To study the problems, complications and functional outcome of fracture stabilization. To analyze and establish methods to the optimally manage the issues involved. Materials and Methods: A review of patients admitted in the orthopaedic department at our institution who presented with or developed compartment syndrome and associated with fractures were chosen. Passive stretch pain and serve pain out of proportion were the main clinical indicators considered. Decision to perform fasciotomy was carried out based on the differential P value and were treated with double incision fasciotomy Patients were followed up every month for the first 6 months and then every 6 months. All the patients, who were reviewed, were functionally assessed based on Upper Extremity Functional Index (UEFI) and Lower Extremity Functional Scale (LEFS). Results: A high suspicion of compartment syndrome must be maintained for all cases. The early diagnosis and treatment within 12 hours is critical to reduce morbidity and prevent any long term sequale. Compartment syndrome causes delay in bone healing. Risk of infection is not increased.