The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
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Case Reports Comparative Study
Outcome of a Specific Compartment Fasciotomy Versus a Complete Compartment Fasciotomy of the Leg in One Patient With Bilateral Anterior Chronic Exertional Compartment Syndrome: A Case Report.
Chronic exertional compartment syndrome of the leg is a debilitating lower extremity condition in which increased intracompartmental pressure impedes blood flow to the involved compartments of the distal lower extremity, resulting in ischemia and pain. Owing to the lack of success with conservative management, most surgeons perform complete release fasciotomy as the preferred method of fasciotomy to avoid an unsuccessful release or outcome. Studies have been performed regarding the outcomes of complete compartmental release versus specific compartmental release, but no study has been performed comparing complete fasciotomy and compartment-specific fasciotomy in a single patient. ⋯ In general, the range of motion, circumferential measurements, and functional outcome measure scores were better for the specific compartmental fasciotomy leg than for the complete fasciotomy leg during the recovery period. The overall functional outcomes were the same for both surgical approaches, with the specific fasciotomy leg returning to baseline function 13 to 23 days before the complete fasciotomy leg. The outcomes remained unchanged 18 months after surgery.
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The current guidelines for the management of diabetes in adults have recommended strict glycemic control, with a target hemoglobin A1c of 7.0%. Increasing evidence has shown that strict glycemic control decreases the risk of developing the organ system complications associated with diabetes. Elevated hemoglobin A1c levels have been theorized as a risk factor for complications after elective foot and ankle surgery. ⋯ The present retrospective observational investigation has demonstrated glycemic control influences the postoperative complication rates in elective foot and ankle surgery. However, the data collected from the present study have also demonstrated that the complication rates are multifactorial. Comorbid conditions and the presence of peripheral neuropathy also play a significant role in determining a patient's risk of complications after elective foot and ankle surgery.