A case of acute compartment syndrome of the leg following prolonged lithotomy position during urological surgery

Abstract Acute compartment syndrome of the lower extremities after urological surgery in the lithotomy position is a rare but potentially devastating clinical and medicolegal problem. We report the case of a 67-year-old male who underwent laparoscopic prostatectomy surgery to treat cancer, spending 180 minutes in surgery. Postoperatively, the patient developed acute compartment syndrome of both legs, needing emergency bilateral four-compartment fasciotomies, with repeated returns to the operating room for second-look procedures. The patient also exhibited delayed wound closure. He regained full function within 6 months, returning to unimpaired baseline activity levels. This report aims to highlight the importance of preoperative awareness of this severe complication which, in conjunction with early recognition and immediate surgical management, may mitigate long-term adverse sequelae and improve postoperative outcomes.

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Lower Limb Acute Compartment Syndrome After Colorectal Surgery in Prolonged Lithotomy Position

Diseases of the Colon & Rectum ◽

10.1007/s10350-006-0712-1 ◽

2006 ◽

Vol 49 (11) ◽

pp. 1772-1780 ◽

Cited By ~ 41

Author(s):

Stefania Beraldo ◽

Simon R. Dodds

Keyword(s):

Colorectal Surgery ◽

Compartment Syndrome ◽

Lower Limb ◽

Acute Compartment Syndrome ◽

Lithotomy Position

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Dorsal Hemi-Lithotomy Position for Femoral Fracture Nailing and the Well Leg Compartment Syndrome. Report of Two Cases, Review of the Literature

Swiss Surgery ◽

10.1024/1023-9332.8.4.193 ◽

2002 ◽

Vol 8 (4) ◽

pp. 193-196 ◽

Cited By ~ 3

Author(s):

Christodoulou ◽

Garofalo ◽

Echeverri ◽

Pelet ◽

Mouhsine

Keyword(s):

Compartment Syndrome ◽

Femoral Fracture ◽

Lithotomy Position ◽

Review Of The Literature ◽

Revue De La Littérature ◽

Examen Clinique ◽

Positionnement Du Patient ◽

Syndrome Report

Le syndrome de loge sur positionnement prolongé en lithotomie ou en hémilithitomie, est une complication rare en chirurgie. Les dommages neurovasculaires sont souvent permanents. On reporte deux cas d'ostéosynthèse du fémur en position d'hemilithotomie, compliqués d'un syndrome de loge de la jambe controlatérale. Une revue de la littérature sur les 40 cas décrits, jusqu'à ce jour, nous démontre que cette complication est fortement liée au positionnement du patient et à la durée opératoire. Compte tenu du pronostic fonctionnel incertain, une limitation du temps de positionnement en lithotomie doit être recherchée. La surveillance postopératoire doit être rigoureuse et sans hésitation quant à une fasciotomie éventuelle sur simple examen clinique ou après la mesure de la pression dans les loges. Une technique de positionnement sur la table orthopédique est proposée.

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Acute Compartment Syndrome of the Thigh in Combat Casualties

Journal of Surgical Orthopaedic Advances ◽

10.3113/jsoa.2013.0042 ◽

2013 ◽

Vol 22 (01) ◽

pp. 42-49 ◽

Cited By ~ 10

Author(s):

Brendan D. Masini ◽

Adam W. Racusin ◽

Joseph C. Wenke ◽

Tad L. Gerlinger ◽

Joseph R. Hsu

Keyword(s):

Compartment Syndrome ◽

Acute Compartment Syndrome ◽

Combat Casualties

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Faculty Opinions recommendation of The estimated sensitivity and specificity of compartment pressure monitoring for acute compartment syndrome.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718001450.793475575 ◽

2013 ◽

Author(s):

Edilson Forlin

Keyword(s):

Compartment Syndrome ◽

Sensitivity And Specificity ◽

Acute Compartment Syndrome ◽

Compartment Pressure ◽

Pressure Monitoring

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Does the shoe-lace technique aid direct closure of fasciotomy wounds after acute compartment syndrome of the lower leg? a retrospective case-control study

Scandinavian Journal of Surgery ◽

10.1177/14574969211019639 ◽

2021 ◽

pp. 145749692110196

Author(s):

P. Suomalainen ◽

T.-K. Pakarinen ◽

I. Pajamäki ◽

M. K. Laitinen ◽

H.-J. Laine ◽

...

Keyword(s):

Compartment Syndrome ◽

Outcome Measurement ◽

Controlled Trial ◽

Lower Leg ◽

Conventional Technique ◽

Tibia Fracture ◽

Acute Compartment Syndrome ◽

Retrospective Case ◽

Direct Closure ◽

Patient Database

Background & aim: Tibia fractures are relatively common injuries that are accompanied with acute compartment syndrome in approximately 2% to 20% of cases. Although the shoe-lace technique, where vessel loops are threaded in a crisscross fashion and tightened daily, has been widely used, no studies have compared the shoe-lace technique with the conventional one. The aim of this study was to compare the shoe-lace technique with the conventional technique. Materials and Methods: We identified 359 consecutive patients with intramedullary nailed tibia fracture and complete medical records including outpatient data between April 2007 and April 2015 from electronic patient database of our institute. The use of the shoe-lace technique was compared to conventional one (in which wounds were first left open with moist dressings). Main outcome measurement is direct closure of fasciotomy wounds. Results: From 359 consecutive patients with intramedullary nailed tibia fracture, fasciotomy was performed on 68 (19%) patients. Of these, the shoe-lace technique was used in 47 (69%) patients while in 21 (31%) patients, the shoe-lace technique was not applied. Side-to-side approximation was successful in 36 patients (77%) in the shoe-lace+ group and 7 patients (33%) in the shoe-lace– group (p = 0.002). Conclusion: The main finding of our comparative study was that the shoe-lace technique seems to ease direct closure of lower leg fasciotomy wounds, and thus reduces the frequency of free skin grafts. Our finding needs to be confirmed in a high-quality randomized controlled trial.

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