1: J Trauma  1996 Mar;40(3):342-4 

Lower limb compartment syndrome: course after delayed fasciotomy.

Finkelstein JA, Hunter GA, Hu RW.

Division of Orthopaedic Surgery, Sunnybrook Health Science Centre, Toronto,
Ontario, Canada.

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 was a delay of more than 35 hours
after the injury. The average ischemic time was 56 hours (range 35-96 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.

PMID: 8601846 [PubMed - indexed for MEDLINE]