Compartment syndrome and its treatment in peripheral arterial trauma

Introduction: In each case with important peripheral vascular injury one of the crucial problems to be solved is the installation of the compartment syndrome. Material and methods: From August 1999 till March 2005 we treated 77 patients with important arterial injuries of the limbs . The range in age was from 13 to 65 years old . In 62 patients the injury was in lower limbs , in 15 the injury was in upper ones. The injuries were causalities of shotguns in 55 cases , knives and other sharp objects in 17 cases , road incidents in 4 cases and iatrogenic 2 cases. We performed fasciotomy in 29 cases. All of them in the legs. In the cases we performed fasciotomy complexity of trauma was 93 % . The rest of cases had a complexity of 15 %. Mean time of addmition in our department from the moment of trauma was 16.5 hours in fasciotomy group and 6. 5 hours in non fasciotomy group. In the cases with fasciotomy revascularization procedures have been performed in 85 % of patients. Whereas in the cases without fasciotomy revascularization procedures were performed in 100 % of cases. Results: In the cases treated with fasciotomy 26 patients did well versus 32 in non fasciotomy group. Amputation in different levels were performed in three cases in fasciotomy group and one in the other group. Neuropathy was installed in 2 patients with fasciotomy versus 1 patient without fasciotomy. Muscular necrosis suffered 3 patients with fasciotomy. Mean duration of stay in hospital was 19 days in the group with fasciotomy and 10 days in the group without. Conclusions Fasciotomy should be performed as soon as possible in all cases where a compartment syndrome is installed