Compartment Syndrome After Tibial Intramedullary Nail Removal and Intramedullary Debridement: A Case Report. Issue 1 (16th January 2023)

• Record Type: Journal Article
• Authors: Gong, Davin C.; Patel, Vandan; Farrar, Nicholas; Hake, Mark E.; Perdue, Aaron M.; Ahn, Jaimo
• Is Part Of: JBJS case connector. Volume 13:Issue 1(2023)
• Publication Date: 2023-01-16
• Subjects: acute compartment syndrome -- compartment syndrome -- ACS -- RIA -- reamer-irrigator-aspirator -- intramedullary debridement -- cortical aspirate -- hardware removal -- tibial nail -- open fracture -- fasciotomy -- fasciotomies -- reamer -- reaming -- bone harvesting -- interlocking screws -- pneumatic -- tourniquet -- IM nail -- pain -- paresis -- paresthesia -- passive stretch -- anterior -- compartment -- infection -- muscle necrosis -- DePuy Synthes -- static-locking -- irrigation -- callus -- male -- middle age -- tibia fracture -- delayed presentation -- edema -- ankle foot orthosis -- AFO -- foot drop -- neurovascular -- ischemia -- reperfusion -- bleeding -- screw tracts -- high volume -- fluid -- perfusion -- communication -- nonviable -- negative pressure therapy -- two-incision fasciotomy -- urgent -- decompression; Orthopedic surgery -- Case studies -- Periodicals; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic Procedures; Orthopedic surgery; Periodicals; Electronic journals; Case studies; Periodicals; 616.7
• DOI: 10.2106/JBJS.CC.22.00365
• Languages: English
• ISSNs: 2160-3251

Abstract

Abstract : Case: A 45-year-old man who sustained an open tibial shaft fracture treated with intramedullary (IM) nailing 9 years earlier presented with persistent pain and concern for occult infection. He underwent tibial nail removal and debridement with reamer-irrigator-aspirator. Postoperative course was complicated by acute compartment syndrome. Conclusion: This is a unique case of postoperative compartment syndrome after IM debridement and tibial hardware removal. A high index of suspicion should be prioritized in patients who complain of severe or unexpected pain to mitigate delays in diagnosis and aid in early treatment.