An analysis of 134 surgically treated compartment syndromes of the lower leg was combined with a long-term follow-up concerning late sequelae. Direct trauma including simple closed as well as severely comminuted open fractures of the tibia and fibula were predisposing factors for the development of a compartment syndrome. Clinical symptoms led to the correct diagnosis, supported by intracompartmental pressure measurements. A unilateral parafibular dermatofasciotomy involving opening all four compartments was the therapy of choice. Fifty-nine per cent of the patients had no late sequelae at the 4.2 year follow-up. 12% poor results were characterized by loss of function and neurological deficits. This group included 8 amputations above the knee due to ischemic/infectious muscle necrosis. The time interval between trauma and operation was found to be the main contributing factor to the poor results, with a delay of 23 h due to secondary referral of the patients. Fasciotomy per se showed only minimal morbidity and is strongly recommended as an emergency procedure.
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