A Prospective Study of Surgical Outcomes and Quality of Life in Severe Foot Trauma and Associated Compartment Syndrome After Fasciotomy

• Published in: The Journal of foot and ankle surgery Vol. 54; no. 3; pp. 417 - 423
• Main Authors: Han, Fucai, MRCS, Daruwalla, Zubin J., MCh (Orth), Shen, Liang, PhD, Kumar, V. Prem, FRCS
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2015
• Subjects: Adult; blunt trauma; Compartment Syndromes - diagnosis; Compartment Syndromes - etiology; Compartment Syndromes - surgery; Decompression, Surgical; early fasciotomy; Fasciotomy; Female; foot compartment syndrome; Foot Injuries - complications; Foot Injuries - surgery; Humans; Male; Middle Aged; Orthopedics; predictors of outcomes; Prospective Studies; Quality of Life; Recovery of Function; Time-to-Treatment; Treatment Outcome; Wounds, Nonpenetrating - complications; Wounds, Nonpenetrating - surgery; Young Adult; foot compartment syndrome; 4; quality of life; early fasciotomy; predictors of outcomes; blunt trauma
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2014.09.015

Abstract The purpose of the present prospective study was to analyze the predictors of outcome and review the quality of life of patients who underwent emergency fasciotomy for foot compartment syndrome after blunt trauma. A total of 14 patients were identified and followed for an average of 24 (range 14 to 33) months. The mean interval from initial presentation to decompressive fasciotomy was 5.8 (range 3 to 11) hours. The follow-up data from our patients revealed satisfactory functional and quality of life outcomes, with 11 of 14 (78.6%) able to return to work. Two (14.3%) patients developed claw-toe deformities and 3 (21.4%) patients had sensory deficits directly attributed to compartment syndrome. Finally, 4 (28.6%) patients required modified shoes or shoe inserts for comfortable ambulation. Our findings suggest that earlier fasciotomy results in better quality of life scores, American Orthopaedic Foot and Ankle Society scale scores, and visual analog scale pain scores and a greater likelihood of being able to wear all shoes comfortably, ambulate independently, and return to work. A shorter interval to fasciotomy, younger age, the absence of bony injury, the absence of other concomitant injuries, and a low velocity crush injury all tended to be predictors of good outcomes at the final review.