Open Tibia Fracture with Compartment Syndrome

In a series of 104 open tibia fractures, six patients developed compartment syndromes involving all four compartments of the lower leg, four of which developed after initial debridement and reduction. The presence of an open tibia fracture with a displaced, comminuted, fibula fracture should suggest the possibility of a developing compartment syndrome. Clinical symptoms include: increasing muscle pain which can be exaggerated by stretching; loss of sensation; decrease in muscle strength; and palpably swollen compartments. Double fasciotomy incisions may lead to adequate decompression, but result in marked loss of soft tissue support for the fracture. To sustain stability, a single posterolateral incision is recommended for compartmental decompression.