It is important to realize that in this study the duration of the compartmental syndrome before surgical decompression was determined retrospectively from the time that the earliest evidence of functional deficits appeared, not the time at which the syndrome was diagnosed by the physician caring for the patient. Motor deficits resulting from a compartmental syndrome are initially treated with appropriate orthotic devices, e.g., a drop foot brace when the anterior compartment of the leg is affected. If function does not return in about one year, tendon transfer and other forms of reconstructive surgery may be considered. Hypesthesia and painful dysesthesia can also result from a compartmental syndrome. These may resolve slowly with time.
Infection can be a serious complication of a compartmental syndrome.
In our retrospective reviews 11 of 24 extremities having late surgical decompression developed infections. Five, or almost one-half, of these infections led to an amputation. One case of osteomyelitis occurred in a patient with an initially closed tibial fracture who underwent fasciotomy and primary closure 28 hours after the onset of the compartmental syndrome. Infection appears to be most frequent in the presence of devitalized muscle, particularly if skin closure has been attempted. Infected compartments are treated by wide opening of dressings, skin, and fascia, thorough lavage of all affected areas, and debridement of infected tissue.