The diagnosis and treatment of compartment syndromes after calcaneal fractures
- VernacularTitle:跟骨骨折合并肌筋膜间室综合征的诊断与治疗
- Author:
Xuhui ZHOU
;
Lianshun JIA
;
Xiongsheng CHEN
- Publication Type:Journal Article
- Keywords:
Calcaneus;
Fractures;
Compartment syndromes
- From:
Chinese Journal of Orthopaedics
1999;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the diagnosis and treatment of compartment syndromes of the foot after calcaneal fractures. Methods Between October 1994 and June 1999, the intracompartmental pressures of foot were measured with the Whitesides method for 98 patients with calcaneal fractures. The interstitial pressures in 9 patients averaged 46 mmHg (range from 30 to 55 mmHg). All of the 9 patients were treated by fasciotomy through a hindfoot medial incision, then each intracompartment pressure were measured,respectively. An interosseous compartment pressure still was 40 mmHg. The patient whose foot had a severe crushing injury had fasciotomy of his interosseous compartment through two dorsal forefoot incisions. After a week, the wounds were covered with a split thinkness skin graft. The calcaneal fractures were treated with open reduction and internal fixation at 2 weeks after fasciotomy through a lateral incision. Results All of the 9 patients were followed up for a mean of 2 years (range from 18 to 35 months) after injury. Two patients had occasional hindfoot and ankle pain after walking or standing for a long time. One of them decreased pin stick sensation and two point discrimination. None of the cases developed stiffness of the forefoot or claw toes, nor soft tissue contracture and motor deficit. Conclusion It should not be neglected that the compartment syndromes of the foot may occur after calcaneal fractures. Intracompartment pressure measurements should be performed to confirm the diagnosis. Fasciotomy, which could be performed through a medial hindfoot incision, is the optimal way of treatment.
