Lower limb compartment syndrome: Course after delayed fasciotomy

Objective: To determine the end result of patients who underwent delayed fasciotomy, i.e,, more than 35 hours for an established lower limb compartment syndrome. Design: A retrospective review of patients undergoing delayed treatment for a closed injury of the lower extremity, where fasciotomy should ideally have been performed earlier. Materials and Methods: Nine fasciotomies in five patients were identified where there,vas a delay of more than 35 hours after the injury, The average ischemic time was 56 hours (range 35-95 hours). Results: One patient died of multiorgan failure and septicemia, The remaining four patients required lower limb amputation, because of local. infection and septicemia, The one late amputation was performed 6 months after the injury, because the patient was left with a functionless insensate foot, Where recognition of an established compartment syndrome is delayed for more than 8 to 10 hours, we propose that the traditional inevitable fasciotomy be reassessed.