PubMed · 7206916
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G Danckwardt-Lillieström, G Karlström, S Olerud. 1980-11-19. [Compartment syndrome].. https://pubmed.ncbi.nlm.nih.gov/7206916/
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Acute compartment syndrome is a serious complication to tibial fractures. The reported incidence is 1-10%. The present series includes 60 patients treated with intramedullary nailing of fractures in the tibial diaphysis. Tissue pressure was measured in 31 patients. Decompressive fasciotomy was performed if the pressure exceeded 30 mm Hg for more than 30 minutes. Follow-up showed no patients with clinical sequelae from a compartment syndrome, but the incidence of fasciotomy was as high as 18%.
A seven-week-old infant suffered a closed segmental fracture of the left tibia and fibula complicated by vascular disruption and a secondary compartment syndrome. Initial orthopedic assessment revealed a clinically mottled, cool, pulseless extremity 4 hr post-injury. Radiologic investigations showed multiple displaced fractures of both the tibia and fibula. The infant underwent four compartment fasciotomies and intramedullary nailing of the tibial fractures. The vascularity of the limb failed to improve significantly. Angiograms done 22 hr post-injury revealed disruption of arterial inflow just distal to the bifurcation of the tibial peroneal trunk and posterior tibial artery. Urgent revascularization utilizing a contralateral greater saphenous vein graft was undertaken with a successful outcome. Despite delay in transport from the community hospital and lack of definitive management of the vascular injury, the infant has had a good-to-excellent functional outcome.
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