An observational study of complications in patients with established multiple compartments syndrome of the leg

Abstract

Introduction: Established multiple compartments syndrome of the leg (EMCSL) is defined as permanent ischemic lesions of muscles and nerves of the compartment, leading to multiple muscle contractions, muscle weakness and wasting and reduced limb sensation. The leg is seriously affected and the patient is unable to return to prior activities. The objective of this research is to quantify long-term consequences, morbidity and socioeconomic impact of established multiple compartments syndrome of the leg Materials and methods: 28 patients suffering from complications from EMCSL were referred to our clinic for secondary management between January 2012 and April 2016 and were followed for mean 41.4 months. Reconstructive procedures to address multiple conditions following established tibia compartment syndrome were performed. The number of reconstructive procedures, days of hospitalization, relationship, educational and employment status per patient were recorded. Preop and postop SF-12 score at final follow-up was documented for the 21 patients who were operated on. Results: A median of three reconstructive procedures was performed per patient for 21 patients. The hospitalization period ranged from 6 to 365 days, with a mean period of 47.5 days (SD 71.4). At the final follow-up, 19 patients had lost their occupation, 3 patients had returned to lighter manual labor, 5 patients had lost two school years, and 1 patient had abandoned school. At the time of injury, 24 patients were single. At final follow-up, 19 of these patients, with a mean age of 38.5 years, were still single. Preoperative and postoperative (at final follow-up) physical and mental components of the SF-12 score had a statistically significant difference (p < 0.001), but final values were not normal. Conclusions: Despite advancements in surgical reconstructive intervention, patients with established compartment tibia syndrome experience permanent grave residual disability with personal and social implications. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.