Fasciotomy versus amputation in patients with compartment syndrome in Bam earthquake victims

ABSTRACT

Compartment syndrome following the injuries in earthquake is a big problem and may cause amputation and psychological problems. The aim of this study was evaluation of the effects of fasciotomy on the prognoses of these patients, especially for the function of the limbs and the function of the kidneys. In a clinical trial all patients referred to Alzahra hospital in Isfahan city from the Bam earthquake area, were taken part in this study. The compartment pressure were measured and following suitable liquid therapy, they were fasciotomized. Then, the bloodshed, infections, fever and the prognoses of the operation especially the need for amputation were recorded. The kidney function was also evaluated by measuring the creatinin. Twenty patients out of 255 patients referred to Alzahra hospital, from the Bam earthquake had compartment syndrome in 26 limbs. This patients were fasciotomized. The average of their age was 36.1 years and 55% of them were female. 1.1 cases had pulses in their limbs. However, all of them had hardness and inflammations in their limbs, without any function. Before surgery, 5 patients had increased blood creatinin. 2 months after surgery, all patients had normal kidney function. 3 patients had amputation. Fasciotomy in patients with compartment syndrome may rescue patients limbs, without any significant adverse effects on their kidney function, and is recommended for all patients with this particular problem: