Abstract
Introduction : This article presents a case of acute compartment syndrome of the foot following open reduction and internal fixation of an ankle fracture. After have a tree fall onto his ankle, a 34 year old fit and well Caucasian male tree surgeon was admitted with a left lateral malleolus and distal tibia fracture. The original plan was to internally fix the large medial fragment with a condylar plate and similarly internally fix the lateral side with a fibular plate. An 8 holes plate was fitted on the lateral side and (due to the presence of fracture blisters) 2 x6.5mm cannulated screws on the medial side were used. It was then noted on day 1 post operation that the pain was not controlled despite using the PCA and oral analgesics. The patient also started to complain of paraesthesia and numbness over the plantar aspect of the operated ankle.
Highlights
This article presents a case of acute compartment syndrome of the foot following open reduction and internal fixation of an ankle fracture
Foot compartment syndrome in association with injury to the ankle is rare, with only 4 case reports found in the literature
Foot compartment syndrome is most often associated with high-energy injuries such as those sustained after a fall from height, crush injury, or motor vehicle collision
Summary
Foot compartment syndrome decompression has been described in many ways, including 2 dorsal incisions for access to forefoot compartments with 1 medial incision for decompression of calcaneal, medial, superficial, and lateral compartments (Manoli and Weber, 1990; Andemahr, 2001). The classic clinical findings of compartment syndrome are less reliable in the foot, and intercompartmental pressure measurements may be necessary for diagnosis This case report raises awareness of the uncommon foot compartment syndrome occurring after a very common injury of an ankle fracture combined with a crush injury. The case report highlights the importance of keeping a high index of suspicion when treating any crush injury, being careful to not be distracted by any associated bony injury. This patient had a good initial outcome due to prompt intervention, the authors quite rightly took the approach to this injury as a ‘soft tissue injury that happened to have an associated broken bone’. A copy of the written consent is available for review by the Editor of this journal
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