Skip to main content
NCBI home page
Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1988 Nov;70(6):372–376.

Does oedema following lower limb revascularisation cause compartment syndromes?

D J Scott 1, M J Allen 1, P R Bell 1, M McShane 1, M R Barnes 1
PMCID: PMC2498632  PMID: 3207329

Abstract

Oedema of the leg, particularly the calf, is a well-recognised complication following lower limb reconstructive vascular surgery, but its effect on the limb is unknown. In this study, anterior compartment pressures and calf circumference were measured in both the operated and non-operated limbs following femoropopliteal bypass in 15 patients. All the patients developed lower limb swelling, which was significantly greater than the non-operated limb, P less than 0.05 paired t test (day 2-5). There was a significant difference in the mean anterior compartment pressures between the operated and non-operated limbs on the third and fourth postoperative days for the overall and below knee group, P less than 0.05 (paired t test). However, none of the patients developed signs, symptoms or pressures indicative of a compartment syndrome. These results suggest that the oedema following reconstructive vascular surgery is subcutaneous rather than compartmental in origin and that compartment pressure measurements should only be undertaken if a fasciotomy is being contemplated.

Full text

PDF
372

Images in this article

374fig. 2
on p.374

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Eickhoff J. H. Normalization of local blood flow regulation in the ischemic forefoot after arterial reconstruction. Surgery. 1985 Jan;97(1):72–82. [PubMed] [Google Scholar]
  2. FRENCH E. B., PRICE W. H. Anterior tibial pain. Br Med J. 1962 Nov 17;2(5315):1290–1296. doi: 10.1136/bmj.2.5315.1290. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Filippone N. D., Shah D. M., Welch H. F., Powers S. R., Jr Chronic venosus obstruction as a factor in the early failure of bypass grafts in the leg. Am J Surg. 1980 Nov;140(5):671–674. doi: 10.1016/0002-9610(80)90055-0. [DOI] [PubMed] [Google Scholar]
  4. Gibson M. J., Barnes M. R., Allen M. J., Chan R. N. Weakness of foot dorsiflexion and changes in compartment pressures after tibial osteotomy. J Bone Joint Surg Br. 1986 May;68(3):471–475. doi: 10.1302/0301-620X.68B3.3733817. [DOI] [PubMed] [Google Scholar]
  5. Hamer J. D. Investigation of oedema of the lower limb following successful femoropopliteal by-pass surgery: the role of phlebography in demonstrating venous thrombosis. Br J Surg. 1972 Dec;59(12):979–982. doi: 10.1002/bjs.1800591212. [DOI] [PubMed] [Google Scholar]
  6. MALEK P., KOLC J., BELAN A. Lymphography of the deep lymphatic system of the thigh. Acta radiol. 1959 Jun;51(6):422–428. doi: 10.3109/00016925909171115. [DOI] [PubMed] [Google Scholar]
  7. Mubarak S. J., Hargens A. R., Owen C. A., Garetto L. P., Akeson W. H. The wick catheter technique for measurement of intramuscular pressure. A new research and clinical tool. J Bone Joint Surg Am. 1976 Oct;58(7):1016–1020. [PubMed] [Google Scholar]
  8. Mubarak S. J., Owen C. A., Hargens A. R., Garetto L. P., Akeson W. H. Acute compartment syndromes: diagnosis and treatment with the aid of the wick catheter. J Bone Joint Surg Am. 1978 Dec;60(8):1091–1095. [PubMed] [Google Scholar]
  9. Porter J. M., Lindell T. D., Lakin P. C. Leg edema following femoropopliteal autogenous vein bypass. Arch Surg. 1972 Dec;105(6):883–888. doi: 10.1001/archsurg.1972.04180120064012. [DOI] [PubMed] [Google Scholar]
  10. Qvarfordt P., Christenson J. T., Eklöf B., Ohlin P. Intramuscular pressure after revascularization of the popliteal artery in severe ischaemia. Br J Surg. 1983 Sep;70(9):539–541. doi: 10.1002/bjs.1800700911. [DOI] [PubMed] [Google Scholar]
  11. Reneman R. S. The anterior and the lateral compartmental syndrome of the leg due to intensive use of muscles. Clin Orthop Relat Res. 1975 Nov-Dec;(113):69–80. doi: 10.1097/00003086-197511000-00011. [DOI] [PubMed] [Google Scholar]
  12. Rorabeck C. H., Clarke K. M. The pathophysiology of the anterior tibial compartment syndrome: an experimental investigation. J Trauma. 1978 May;18(5):299–304. doi: 10.1097/00005373-197805000-00001. [DOI] [PubMed] [Google Scholar]
  13. Skillman J. J., Dohlman L. E., Gerhart T. N., Ransil B. J. Compartmental pressure monitoring after arterial reconstruction lacks clinical relevance. J Vasc Surg. 1986 Jun;3(6):871–876. doi: 10.1067/mva.1986.avs0030871. [DOI] [PubMed] [Google Scholar]
  14. Vaughan B. F., Slavotinek A. H., Jepson R. P. Edema of the lower limb after vascular operations. Surg Gynecol Obstet. 1970 Aug;131(2):282–290. [PubMed] [Google Scholar]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England

RESOURCES