Surgical treatment and late results of foot compartment syndrome]

From 1982 to 1988 a total of 29 patients with compartment syndrome of the foot were treated by fasciotomy. The most common causes were fracture dislocations of the Lisfranc (n = 14) and Chopart joints (n = 4). Since these injuries lead to a severe damage to soft tissue structures--joint capsules, ligaments, fasciae--the muscular compartments often communicate and decompression can be achieved by a longitudinal dorsal incision of the skin and fasciotomy of the fascia dorsalis pedis and the retinacula extensorum superior and inferior. Subsequent measurement of intracompartmental pressure dictates whether blunt dissection of the interosseous muscles and separate fasciotomy of the medial, lateral and plantar compartments have to be performed. Follow-up was possible in 18 patients: half had good results, while 9 patients had limited motion of their toes and/or paresthesia. It is impossible to know whether these negative findings are caused by the compartment syndrome itself or by the severe soft tissue damage resulting from the initial trauma.