Lokesh BhatiaSuch cases never wait more than 24 hrs to go ahead with Fasciotomy, Ex Fix. Compartment Syndrome is Clinical Diagnoisis, High index of suspicion is key to success, Although you have not mentioned about his of proportion Pain, which is the key feature for diagnosing CS, but if it so don’t wait go ahead with emergency Fasciotomy. One never loses anything in over diagnosing Compartment syndrome then risking the limb your reputation, If in doubts take more colleagues opinion, or simply go ahead and do it missing CS is disaster for pt. Delaying Fasciotomy is also disaster, it is not recommended to do it more than 24 hrs, but earlier the better. As limb is vascular jeopardy Ex Fix is justified as Damage Control Orthopaedics let it settle down but Fasciotomy and Skeletal stabilisation will improve limb circulation, Do not hesitate in involving Vasular Surgeon, If thinks necessary go ahead with CT Angio to confirm Limb Vascularity, in case, even after emergency procedure you still vascularity is not better. the concern here is limb and not Good looking Post op Xray.
Naresh Kumar Krishnamurthybetter to go ahead early. can you send the clinical pics? if it is not a established compartment syndrome then can do a mini-incision fasciotomy reduce joint line, slide a lateral plate and leave the fasciotomy open. closely monitor post op.
Santosh RawatBlisters are seen frequently after such fractures, only a fraction develop compartment syndrome. If patients does not have stretch pain, there is no need to panic. Elevate on BB splint, foot higher than knee, cold compresses and sit tight for a couple of weeks. Have a CT with 3D recon and plan your fixation
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