Abstract
Compartment syndrome (CS), a serious complication in paediatric trauma, can be prevented by timely diagnosis and adequate therapy.
From 1990 to 2000 we treated 22 patients with suspected CS in the arm. Incision into the intrafascial spaces of nine forearms and three hands confirmed the diagnosis. In 10 patients, fracture had caused the syndrome, and in two, the cause was contusion. In two patients the CS resulted from incorrect treatment procedures.
We also treated 22 patients with suspected CS in the lower limb. The diagnosis was confirmed in 15. Incision into the intrafascial spaces was performed during treatment, 13 times on the crus and twice on the femur. Fractures were always the primary cause.
In the upper limb outcomes were good. One patient developed a Volkman’s contracture but this was only disfiguring. Some patients treated for lower limb CS had cosmetic after-effects, but only one patient, in whom CS was diagnosed late, had functional after-effects.
We advocate permanent monitoring of intrafascial pressures, using piezoelectric sensors, and timely performance of adequate dermofasciotomies.
The abstracts were edited by Prof. M.B.E. Sweet. Correspondence should be addressed to him at the Department of Orthopaedic Surgery, Medical School, University of the Witwatersrand, 7 York Road, Parktown, 2193 South Africa
