Acute compartment syndrome after intramedullary nailing of tibial shaft fracture. Three case reports

Abstract

Acute compartment syndrome(ACS) is an urgent state in orthopedic surgery, which most often  occurs secondarily to tibial shaft fracture. Delayed diagnosis of ACS can lead to very serious complications, including  limb inefficiency or amputation. The diagnosis of ACS is based on characteristic clinical signs, like pain, paresthesia, pallor, paralysis, pulsessness, and poikilothermia. In patients with disorted logic contact diagnosis may be difficult and introduction of intercompartmental pressure measurement into diagnostic process may be useful. In this article three clinical cases of acute compartment syndrome after tibial diaphyseal fracture treated with intramedullary  reamed locking nail from Departement of Trauma and Orthopedic Surgery will be presented. Profile of those patients fully corresponds to characteristic of patients that are most at risk for this type of complication. All patients were treated with urgent fasciotomy. Additionally, in treatment of wounds  after fasciotomy also negative pressure wound therapy system and hyperbaric oxygen therapy were used. The final outcome of patients’ treatment correlates with time elapsed since the onset of symptoms.