[Acute compartment syndrome in the post-traumatic leg].

PURPOSE OF THE STUDY

Compartment syndrome represents a clinical entity, whose diagnosis depends both on clinical findings as well as on measurement of the intracompartmental pressure. Physiopathology and clinical aspects of diagnosis and treatment of the acute compartment syndrome are discussed, based on the literature review and personal clinical experience.

MATERIAL AND METHODS

We have based our experience on a series of 100 consecutive fractures of the leg, in which we studied mechanism of trauma, fractures localization, timing of surgery for fasciotomy and wound closure.

RESULTS

The incidence of compartment syndrome was 8 per cent. Younger age (< 30 years), high energy trauma, or trauma occurring during physical activity appeared to increase the risk of occurrence. Localization of the fracture on the proximal, mid or distal thirds of the leg did not.

DISCUSSION

The following aspects are discussed: 1) The perfusion pressure of a compartment is defined as the difference between the diastolic blood pressure and the intracompartmental pressure. 2) Fasciotomy is indicated whenever this value is inferior to 30 mmHg. 3) Failure to measure the pressure within 5 cm from the fracture site may cause underestimation of the compartment pressure. 4) Intramedullary nailing does not seem to increase the risk of compartment syndrome.