Compartment Syndrome Surgical Management Techniques Associated with Tibial Plateau Fractures

ABSTRACT

Compartment syndrome is an orthopaedic emergency that can be challenging to diagnose and manage when associated with a tibial plateau fracture. This technique article discusses one- and two-incision fasciotomy surgical techniques, and the surgical decision making and technique modifications when there is an associated tibial plateau fracture.

KEYWORDS

Compartment syndrome - trauma

REFERENCES

• 1 Mubarak S J, Owen C A. Double-incision fasciotomy of the leg for decompression in compartment syndromes.  J Bone Joint Surg Am. 1977;  59 184-187
• 2 Cohen M S, Garfin S R, Hargens A R, Mubarak S J. Acute compartment syndrome. Effect of dermotomy on fascial decompression in the leg.  J Bone Joint Surg Br. 1991;  73 287-290
• 3 Tornetta III P, Templeman D C. Instructional Course Lectures. The American Academy of Orthopaedic Surgeons—Compartment syndrome associated with tibial fracture.  J Bone Joint Surg Am. 1996;  78A 1438-1444
• 4 Maheshwari R, Taitsman L A, Barei D P. Single-incision fasciotomy for compartmental syndrome of the leg in patients with diaphyseal tibial fractures.  J Orthop Trauma. 2008;  22 723-730
• 5 Scully R E, Hughes C W. The pathology of ischemia of skeletal muscle in man; a description of early changes in muscles of the extremities following damage to major peripheral arteries on the battlefield.  Am J Pathol. 1956;  32 805-829
• 6 Stark E, Stucken C, Trainer G, Tornetta III P. Compartment syndrome in Schatzker type VI plateau fractures and medial condylar fracture-dislocations treated with temporary external fixation.  J Orthop Trauma. 2009;  23 502-506
• 7 Egol K A, Bazzi J, McLaurin T M, Tejwani N C. The effect of knee-spanning external fixation on compartment pressures in the leg.  J Orthop Trauma. 2008;  22 680-685
• 8 Hak D J, Lee M, Gotham D R. Influence of prior fasciotomy on infection after open reduction and internal fixation of tibial plateau fractures.  J Trauma. 2010;  , January 8 (Epub ahead of print)
• 9 Olson S A, Glasgow R R. Acute compartment syndrome in lower extremity musculoskeletal trauma.  J Am Acad Orthop Surg. 2005;  13 436-444
• 10 Kanakaris N K, Thanasas C, Keramaris N, Kontakis G, Granick M S, Giannoudis P V. The efficacy of negative pressure wound therapy in the management of lower extremity trauma: review of clinical evidence.  Injury. 2007;  38(Suppl 5) S9-S18
• 11 Yang C C, Chang D S, Webb L X. Vacuum-assisted closure for fasciotomy wounds following compartment syndrome of the leg.  J Surg Orthop Adv. 2006;  15 19-23
• 12 Wiger P, Tkaczuk P, Styf J. Secondary wound closure following fasciotomy for acute compartment syndrome increases intramuscular pressure.  J Orthop Trauma. 1998;  12 117-121