Calcaneal compartment syndrome after tibial fractures

Arthroscopic and Endoscopic Management of Common Complications After Displaced Intra-Articular Calcaneal Fractures

The list of late complications after calcaneal fracture that can be treated through arthroscopic and/or endoscopic approach continues to expand. The late complications of calcaneal fractures can be classified into 3 groups: (1) those causing focal hindfoot or ankle pain, (2) those causing functional deficit, and (3) those present with diffuse and poorly localized pain. Many group 1 and some group 2 complications can be managed arthroscopically and/or endoscopically. There are usually multiple coexisting sources of the pain. Careful evaluation and analysis of a problem and detailed surgical planning with combination of arthroscopic/endoscopic and open procedures are key to success.

Arthroscopic and Endoscopic Management of Posttraumatic Hindfoot Stiffness

Ankle, hindfoot, and toe stiffness can result from hindfoot trauma. It can be due to capsular fibrosis, tendon adhesion, muscle fibrosis, or malunion. For symptomatic stiffness that is resistant to nonoperative treatment, operative treatment should be considered. It is important to tackle the sources of stiffness, and careful preoperative clinical assessment is the key for proper formulation of the surgical plan. Whenever possible, arthroscopic/endoscopic surgery is preferable to open surgery because less extensive dissection and small surgical incisions allow immediate vigorous mobilization of the foot and ankle.

Hallux varus as complication of foot compartment syndrome

Hallux varus can present as a congenital deformity or it can be acquired secondary to trauma, surgery, or neuromuscular disease. In the present report, we describe the presence of hallux varus as a sequela of calcaneal fracture with entrapment of the medial plantar nerve in the calcaneal tunnel and recommend that clinicians be wary of this when they clinically, and radiographically, evaluate patients after calcaneal fracture.

Acute compartment syndrome of the foot following fixation of a pilon variant ankle fracture

Acute traumatic compartment syndrome of the foot is a serious potential complication after fractures, crush injuries, or reperfusion injury after vascular repair. Foot compartment syndrome in association with injuries to the ankle is rare. This article presents a case of acute compartment syndrome of the foot following open reduction and internal fixation of an ankle fracture. A 16-year-old girl presented after sustaining a left ankle injury. Radiographs demonstrated a length-stable posterior and lateral malleolar ankle fracture. Initial treatment consisted of a bulky splint and crutches pending the improvement of her swelling. Over the course of a week, the soft tissue environment of the distal lower extremity improved, and the patient underwent open reduction and internal fixation of both her fibula and distal tibia through 2 approaches. Approximately 2 hours from the completion of surgery, the patient reported worsening pain over the medial aspect of her foot and into her calcaneus. Physical examination of the foot demonstrated a swollen and tense abductor hallicus and heel pad. Posterior tibial and dorsalis pedis pulses were palpable and her sensation was intact throughout her foot. Emergently, fasciotomy of both compartments was performed through a medial incision. Postoperatively, the patient reported immediate pain relief. At 18-month follow-up, she reported no pain and had returned to all of her preinjury athletic activities.

Salvage of compartment syndrome of the leg and foot

Early diagnosis and treatment of compartment syndrome of the leg or foot is invaluable in avoiding a chronic and often debilitating course. In cases where an ischemic contracture results in pain, disability or soft tissue compromise, surgical intervention is indicated. Thorough physical examination of patients and a thorough understanding of pathomechanics of the foot and ankle are paramount. These combined with a comprehensive preoperative plan and meticulous execution can often provide improved function and decrease pain in patients affected by this debilitating problem.

Tibial compartment syndrome and the cavovarus foot

Compartment syndrome of the leg is an orthopedic emergency that requires a high index of suspicion for diagnosis and a low threshold for surgical management to prevent devastating complications. Where the clinical findings are subtle, continuous monitoring of compartment pressures, with clinical correlation, is the key to diagnosis. Surgical management should include decompression of all four compartments and early rehabilitation to prevent ischemic contracture. If contracture develops, it may cause varying degrees of equinocavovarus deformity of the foot and ankle. Appropriate evaluation and careful surgical planning that considers all components of this complex deformity are essential for obtaining good clinical results.