Compartment syndrome of the foot following trauma is well known in
adults but has not been discussed frequently in texts on pediatric trauma.
In the current study, seven children and teenagers were identified as
having had compartment syndrome of the foot during a five-year period. The
average age at the time of the diagnosis was ten years (range, four to
sixteen years). The cause of the compartment syndrome was a crush injury in
six patients and a motor-vehicle accident in one. All patients had swelling
and pain with passive motion, but none had neurovascular deficits. Only the
two oldest children had an osseous injury that necessitated open reduction
and internal fixation, but all had elevated compartment pressures ranging
from thirty-eight to fifty-five millimeters of mercury (5.07 to 7.33
kilopascals). All seven patients had fasciotomies of the nine compartments
of the foot, and the skin was closed primarily within five days after the
operation. No patient had complications or needed a skin graft. All
patients had a good or excellent result after an average duration of
follow-up of forty-one months (range, twenty-three to fifty-three months).
Orthopaedists managing children who have a traumatic injury of the foot,
especially a crush injury, should have a high index of suspicion for
compartment syndrome, even in the absence of severe fracture.