文献简介

出版社:J Orthopaed Traumatol (2012)

作  者:Nabil A. Ebraheim•Amr A. Abdelgawad• Molly A. Ebraheim•Sreenivasa R. Alla

编  号:10.1007/s10195-012-0196-9

关键字:Compartment| syndrome| Bedside| Fasciotomy| Local| anesthesia| Fascial| release| Urgent surgery

年  份:2012   点击量:412

文献摘要

Background

Fasciotomy for compartment syndrome is an emergent procedure that is usually done in the operating theater under general anesthesia. Delay in performing the procedure can lead to worse outcome. Various reasons can cause delay in performing the surgery. Bedside fasciotomy under local anesthesia can be done in these cases to avoid delay in compartment release.

Materials and methods

This was a retrospective study of 34 cases of acute compartment syndrome for which fasci- otomy was done at the bedside under local anesthesia. The minimum follow-up period was 6 months.

Results

All patients had immediate and marked improvement in pain. Thirty-three patients regained their normal muscle strength. Thirty-two patients regained nor- mal range of motion of adjacent joints. One patient developed flexion contracture of the great toe. There was no deep infection, chronic osteomyelitis, or amputation. Superficial wound infection was noted in three patients; one patient had persistent foot drop.

Conclusion

Bedside fasciotomy under local anesthesia is a feasible, safe, and effective choice for treating compart- ment syndrome in patients with delayed presentation or those with anticipated delay to undergo surgery in the operating theater under general or regional anesthesia. The results of this study are encouraging, as all wounds healed satisfactory and there were no cases of deep infections. The formal release of compartments in the operating room under general anesthesia continues to be the standard of care. This is the first description in the literature for bedside fasciotomy under local anesthesia with a relatively large number of patients.