[Functional sequelae in tibial shaft fractures with compartment syndrome following primary treatment with urgent fasciotomy]

Abstract

In a retrospective study on 28 patients, the incidence, nature and severity of the sequelae after severe lower leg trauma were studied. All patients had a tibial shaft fracture with a complete or impending compartment syndrome, treated with an urgent stabilisation and an adequate decompressive fasciotomy. In a thorough clinical examination, performed 17 months after trauma, the mobility of the knee and ankle joint, the perimetry of the lower leg and foot, and the muscle strength of all lower leg muscles were measured. Contractures were noticed, superficial sensibility was tested and an evaluation of march was done. More than one fourth of the patients showed late functional disabilities, mainly because of limitation of the dorsiflexion of the ankle joint, reduction of the muscle strength of the foot extensors, contractures of the foot flexors and abnormal superficial sensibility. The more severe the primary soft tissue trauma was, the more severe the functional disabilities were. The severity of the soft tissue damage, resulting from the trauma itself, is the most important factor for the late functional result after lower leg trauma. The compartment syndrome is certainly an aggravating factor when it is not treated by urgent fasciotomy. But this does not mean that all patients with lower leg fracture and compartment syndrome, treated with urgent fasciotomy, will show excellent functional end results.