To study the early wound treatment and the late sequelae correction of the patient with lower extremity compartment syndrome.

All of 46 patients, with lower limb compartment syndrome and were performed fasciotomy in other hospital, were admitted to Beijing Jishuitan hospital between January 2008 and December 2012. Eight patients who had severe sequelae at late stage were included this study. A retrospective study was carried out on the 8 patients, the medical and surgical date and functional recovery information were investigated.

Among the 8 cases, 7 cases had different degrees of fracture. All patients had different degrees of nerve injury, and 4 cases had vascular injury. Muscle necrosis involving the anterior and lateral muscle groups in 6 cases, involving the anterior, lateral and posterior deep muscle groups (except for gastrocnemius muscle survival) in 2 cases. Fasciotomy were performed 12-24 hours after injury in 6 cases, and 2 days in 1 cases, the other one cases was treated at the stage of septic necrosis of the muscles involved six months after injury. Necrotic tissue was removed completely after 2-4 times debridement and wound healed with suture in 3 cases, and with skin grafting and suture in 5 cases. All patients had different degrees of sequelae. Neuropathic ulceration occurred at the fifth metatarsal head and healed after wound dressing in 2 cases. Clawed toes and hallux deformity were presented in 4 cases, and the clawed toes were corrected through resection arthroplasty of proximal interphalangeal point (PIP) joints, the clawed hallux were treated by flexor halluces longus tendon lengthening and resection arthroplasty of the first metatarsophalangeal joint. Equinovarus deformity were happened in all the patients and ankle joint achieved 0°dorsiflexion through the application of Ilizarov fixator, 6 cases were gradually returned to normal weight bearing walking without the use of aid, a tibio talar arthrodesis was performed and the ankle joint acquired permanently corrected in 2 cases.

The lower extremity compartment syndrome can cause muscle and nerve ischemia necrosis and lead to serious sequelae. In the early stage, wound debridement should be performed in order to promote wound healing on the basis of the stability of the whole body. Wound debridement, Ilizarov fixator application, and arthrodesis were important methods for the sequential treatment of severe compartment syndrome. However, the best treatment for compartment syndrome was prevention, so did the late sequelae.

Compartment syndrome; Leg bones; Wound management; Late sequelae