The Journal of Bone and Joint Surgery (American). 2006;88:729-737.
doi:10.2106/JBJS.E.00336
© 2006 The Journal of Bone and Joint Surgery, Inc.
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Functional Outcome After Acute Compartment Syndrome of the Thigh

Kai Mithoefer, MD1, David W. Lhowe, MD2, Mark S. Vrahas, MD2, Daniel T. Altman, MD3, Vanessa Erens, DPT4 and Gregory T. Altman, MD3

1 Harvard Vanguard Orthopedics and Sports Medicine, Brigham and Women's Hospital, 230 Worcester Street, Wellesley, MA 02481. E-mail address for K. Mithoefer: kmithoefer{at}partners.org
2 Department of Orthopedic Surgery, Massachusetts General Hospital, 15 Parkman Street, Boston, MA 02114
3 Allegheny General Hospital, 1307 Federal Street, 2nd Floor, Pittsburgh, PA 15212
4 Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215

Investigation performed at Brigham and Women's Hospital, Massachusetts General Hospital, and Beth Israel Deaconess Medical Center, Boston, Massachusetts

A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our subscription department, at 781-449-9780, to order the CD-ROM).

The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Acute compartment syndrome of the thigh is an uncommon condition that is associated with a high rate of morbidity. Because of its rarity, limited information is available on the long-term functional outcome for patients with this condition and the factors that affect the clinical result.

Methods: Eighteen patients with acute compartment syndrome of the thigh were evaluated at an average of sixty-two months after treatment. Functional outcome was evaluated by means of physical examination, isokinetic thigh-muscle testing, and validated functional outcome scores.

Results: Long-term functional deficits were present in eight patients, and only five patients had full recovery of thigh-muscle strength. The persistent dysfunction was reflected in worse overall functional outcome scores. High injury severity scores, ipsilateral femoral fracture, prolonged intervals to decompression, the presence of myonecrosis at the time of fasciotomy, and an age of more than thirty years were associated with increased long-term functional deficits, persistent thigh-muscle weakness, and worse functional outcome scores.

Conclusions: Acute compartment syndrome of the thigh is often associated with considerable long-term morbidity. Several factors can affect the functional outcome, and knowledge of these factors can help in the development of a more effective clinical management strategy to reduce long-term morbidity.

Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.


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Letters to the Editor:

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Femoral Shaft Fractures Without Acute Compartment Syndrome Can Also Lead to Functional Deficit
Jibanananda Satpathy
JBJS Online, 17 May 2006 [Full text]
Dr. Mithoefer et al. reply to Dr. Satpathy
Kai Mithoefer, M.D., et al.
JBJS Online, 13 Jun 2006 [Full text]