Recurrent Compartment Syndrome: 2 Cases and a Review of the Literature
Trevor R. Gaskill, MS, Robert Zura, MD, and J. Mack Aldridge III, MD
Dr. Gaskill is PGY-3 Resident, Division of Orthopaedic Surgery, Dr. Zura is Assistant Professor, Orthopaedic Trauma, Division of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
Dr. Aldridge is Fellowship Deirector, Triangle Orthopaedic Associates, P.A., Durham, North Carolina.
Compartment syndrome is a potentially devastating entity, and timely recognition is critical for appropriate management. Diagnosis is classically a clinical one and based largely on serial examinations. When clinical examinations are compromised, compartment pressure monitoring may be useful. These diagnostic measures, however, assume recognition of “at-risk” injuries or clinical scenarios. Rarely discussed is whether an open fasciotomy provides any degree of protection from redeveloping compartment syndrome.
To this end, we present 2 cases of recurrent compartment syndrome after previous fasciotomy. These reports illustrate a previously unreported at-risk population and demonstrate that compartment syndrome can recur in a previously released compartment. Therefore, prior fasciotomy should not be considered protective against acute compartment syndrome. These patients should be evaluated and managed no differently from patients with primary compartment syndrome.