Compartment syndrome of the non-injured limb

Well leg compartment syndrome due to the lithotomy position in orthopedic surgery: a report of two cases and a review of the literature

The well leg compartment syndrome (WLCS) is a complication that can occur because of the lithotomy surgical position. Although it is a very rare entity, it can lead to a permanent disability if not properly treated. Very few cases have been described in the literature as a result of orthopedic surgery. We present two cases of WLCS that developed because of the lithotomy position. The first case concerns a patient who sustained a left floating knee and developed a compartment syndrome of the right uninjured calf during surgery. A good outcome has been achieved after early fasciotomies. The second case is about a patient who developed a compartment syndrome of the right buttock after a left unicompartmental knee replacement. This patient was treated conservatively because of delayed diagnosis. A brief literature review regarding the WLCS in orthopedic surgery is also conducted.

Developing an in-vivo physiological porcine model of inducing acute atraumatic compartment syndrome towards a non-invasive diagnosis using shear wave elastography

Compartment syndrome (CS) is a pathological event caused by elevated intracompartmental pressure (ICP); however, changes from the onset of inducing atraumatic CS remained unclear. The study aimed to investigate the physiological changes in a newly developed in vivo porcine acute atraumatic CS model. CS was induced by ischemia–reperfusion injury in the left hind leg of fourteen pigs divided into an echogenicity group (EG) and a shear wave elastography group (SEG). Echogenicity was measured in EG, and shear elastic modulus (SEM) was measured in SEG seven times before, at the onset of inducing CS, and every 30 min after the onset over eight hours. Simultaneously, ICP, blood pressure, and muscle perfusion pressure (MPP) were also measured in both groups. Our results indicate that SEM of the experimental leg in SEG significantly increased as CS developed compared to the control leg (p = 0.027), but no statistical difference in the echogenicity in EG was found between the experimental leg and control leg. There were also significant correlations between SEM and ICP (p < 0.001) and ICP and MPP (p < 0.001). Our method and findings can be a basis to develop a non-invasive diagnostic tool using a shear wave elastography for atraumatic CS.