Artikel
Complications following unilateral fasciotomy of the lower leg for compartment syndrome
Suche in Medline nach
Autoren
-
Arnold Suda
- BG Klinik Ludwigshafen, Septische Chirurgie, Ludwigshafen, Germany
-
Christian Abt
- BG Klinik Ludwigshafen, Ludwigshafen, Germany
-
Yoram Weil
- Hadassah Hospital & Hebrew University, Orthopaedic and Reconstructive Trauma Surgery, Jerusalem, Israel
-
Amal Khoury
- Hadassah Hospital & Hebrew University, Orthopaedic and Reconstructive Trauma Surgery, Jerusalem, Israel
-
Ghaith Abou-Nouar
- King Hussein Medical Center, Orthopaedic Department, Royal Medical Services, Amman, Jordan
-
Paul A. Grützner
- BG Klinik Ludwigshafen, Klinik für Unfallchirurgie und Orthopädie, Ludwigshafen, Germany
-
Oliver Bischel
- BG Klinik Ludwigshafen, Klinik für Unfallchirurgie und Orthopädie, Sektion für Endoprothetik, Ludwigshafen, Germany
-
Marco Tinelli
- BG Klinik Ludwigshafen, Klinik für Unfallchirurgie und Orthopädie, Sektion für Endoprothetik, Ludwigshafen, Germany
| Veröffentlicht: | 10. Oktober 2016 |
|---|
Gliederung
Text
Objectives: Unilateral fasciotomy for the Treatment of compartment Syndrome is a Standard procedure but requires experience and can lead to severe complications. Different from the bilateral fasciotomy, all compartiments are opened from lateral side using one Long incision. Aim of this retrospective study was to evaluate the results of this procedure and to identify risk factors for complications.
Methods: 204 patients (173 males, 28 females) were included in this study with a mean Age of 40 years (10 - 91) who developed a compartment Syndrome of the lower leg following an open or closed lower leg fracture, ankle fracture, contusion of the lower leg or without Trauma. Patients were evaluated clinically until discharge in case of no complications or up to one year in the case of complications.
Results and Conclusion: 201 patients were evaluated. 84 Patients (41.8%) developed complications, mostly wound healing Problems (46.4%), partial muscle necrosis (36.9%), disturbance of sensitivity (32.1%), pain (20.2%) and peroneal nerve lesion (19%). Two revisions (1 - 11) were needed until wound closure was reached, including scheduled Change or removal of vacuum assisted closure dressing.
There was no statistical significant difference regarding comorbidities in patients with or without complications.
Unilateral fasciotomy is a limb preserving procedure in the case of manifest compartment Syndrome of the lower leg. The results of this study Show the high rate of complications with 19% of peroneal nerve lesions. Although the lower leg injury can cause nerve injury itself, the unilateral technique contains the risk of iatrogenic nerve injury. Evaluating our results, the bilateral faciotomy using smaller incisions on the lateral side might prevent nerve injuries.
