Kai Mithoefer, MD1, David W. Lhowe, MD2, Mark S. Vrahas, MD2, Daniel T. Altman, MD3, Vanessa Erens, DPT4 and Gregory T. Altman, MD3
1 Harvard Vanguard Orthopedics and Sports Medicine, Brigham and Women’s Hospital, 230 Worcester Street, Wellesley, MA 02481. E-mail address for K. Mithoefer: firstname.lastname@example.org 2 Department of Orthopedic Surgery, Massachusetts General Hospital, 15 Parkman Street, Boston, MA 02114 3 Allegheny General Hospital, 1307 Federal Street, 2nd Floor, Pittsburgh, PA 15212 4 Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215
Background: Acute compartment syndrome of the thigh is an uncommon condition that is associated with a high rate of morbidity. Because of its rarity, limited information is available on the long-term functional outcome for patients with this condition and the factors that affect the clinical result.
Methods: Eighteen patients with acute compartment syndrome of the thigh were evaluated at an average of sixty-two months after treatment. Functional outcome was evaluated by means of physical examination, isokinetic thigh-muscle testing, and validated functional outcome scores.
Results: Long-term functional deficits were present in eight patients, and only five patients had full recovery of thigh-muscle strength. The persistent dysfunction was reflected in worse overall functional outcome scores. High injury severity scores, ipsilateral femoral fracture, prolonged intervals to decompression, the presence of myonecrosis at the time of fasciotomy, and an age of more than thirty years were associated with increased long-term functional deficits, persistent thigh-muscle weakness, and worse functional outcome scores.
Conclusions: Acute compartment syndrome of the thigh is often associated with considerable long-term morbidity. Several factors can affect the functional outcome, and knowledge of these factors can help in the development of a more effective clinical management strategy to reduce long-term morbidity.
The Journal of Bone and Joint Surgery (American). 2006;88:729-737.