eMedicine Specialties > Physical Medicine and Rehabilitation > Lower Limb Musculoskeletal Conditions

Compartment Syndrome: Follow-up

Author: Abraham T Rasul Jr, MD, Medical Director for Rehabilitation, Specialty Hospital of Washington; Medical Director for Rehabilitation, St Thomas More Medical Complex; Founder, Arizona Golf Medicine Institute
Contributor Information and Disclosures

Updated: Mar 11, 2009

Follow-up

Complications

  • With late diagnosis, irreversible tissue ischemia can develop in the acute setting. Thus, permanent muscle and nerve damage, along with chronic pain, may occur. Peroneal nerve palsy, in particular, may develop. With muscle damage, muscle contractures may be observed.
  • Infection is a major issue after fasciotomy and in some cases becomes chronic. Patients, especially those with multiple traumatic injuries, may die because of infections or metabolic complications. Renal failure or multiple organ failure may occur preoperatively or postoperatively.
  • Calcific myonecrosis of lower extremity muscles has been identified as an uncommon late complication of posttraumatic compartment syndrome. On radiographs, peripheral calcifications may be observed around a fusiform mass.

Prognosis

  • Long-term follow-up of patients who have undergone fasciotomies has shown good results, with a return to premorbid activity level. Pain also has been found to significantly improve. The results of fasciotomies for posterior compartment syndrome are not as good as those for the anterior compartment. A possible explanation is that it is difficult to do a complete decompression of the deeper posterior compartment, due to the morbidity associated with this procedure. In general, however, early diagnosis, with institution of the appropriate treatment, results in a good outcome.

Miscellaneous

Medicolegal Pitfalls

  • Delay in diagnosis (or misdiagnosis) can lead to failure to provide appropriate treatment, increasing the risk of complications, such as nerve entrapment, vascular compromise, tissue necrosis, and/or chronic pain.
  • As previously mentioned, the long-term prognosis for patients with posterior compartment syndrome is less favorable than that for patients with the anterior variety.
  • If surgical management is undertaken, the usual surgical and postsurgical risks must be considered (eg, anesthesia risk, infection, deep vein thrombosis, pulmonary embolism).
 


More on Compartment Syndrome

Overview: Compartment Syndrome
Differential Diagnoses & Workup: Compartment Syndrome
Treatment & Medication: Compartment Syndrome
Follow-up: Compartment Syndrome
References
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References

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Further Reading

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Keywords

compartment syndrome, fasciotomy, anterior compartment syndrome, compartmental syndrome, acute compartment syndrome, exertional compartment syndrome, compartment pressure, intracompartmental pressure

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Contributor Information and Disclosures

Author

Abraham T Rasul Jr, MD, Medical Director for Rehabilitation, Specialty Hospital of Washington; Medical Director for Rehabilitation, St Thomas More Medical Complex; Founder, Arizona Golf Medicine Institute
Abraham T Rasul Jr, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American College of Sports Medicine, and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Rajesh R Yadav, MD, Assistant Professor, Section of Physical Medicine and Rehabilitation, MD Anderson Cancer Center, University of Texas at Houston
Rajesh R Yadav, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Patrick M Foye, MD, FAAPMR, FAAEM, Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School
Patrick M Foye, MD, FAAPMR, FAAEM is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society
Disclosure: Nothing to disclose.

CME Editor

Kelly L Allen, MD, Regional Medical Director, IMX-Medical Management Services
Disclosure: Nothing to disclose.

Chief Editor

Consuelo T Lorenzo, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Alegent Health Care, Immanuel Rehabilitation Center
Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.

 
 
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