Christoffersen et al reported risk factors for well leg compartment syndrome (WLCS) following abdominal surgery. The authors are from Danish Patient Compensation Association, Hvidovre Hospital and Bispebjerg-Frederiksberg Hospital in Denmark.
Patient selection: abdominal surgery
Proposed mechanism: ischemia with reperfusion, causing muscle swelling
Clinical features:
(1) onset of symptoms 12-48 hours of surgery
(2) pain in the calf
(3) elevated serum CK
Key risk factors:
(1) elevated legs during surgery, especially when> 4 hours
(2) longer duration of surgery
Additional risk factors may include:
(1) method of elevating the legs (greater with compression of vessels and nerves)
(2) anti-thrombotic compression stockings
Acute four-compartment fasciotomy of the lower leg is the usual management.
To read more or access our algorithms and calculators, please log in or register.
