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Pediatric Case of Compartment Syndrome Secondary to Intravenous Infiltration Injury

Dr. Jason Cacioppo, Samuel Corey
Indiana University School of Medicine
2013-03-15

Presenter: Samuel Corey

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Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction

Rare in the literature are discussions of elevated compartment pressure in the foot. Rarer still are cases requiring fasciotomy subsequent to compartment syndrome. There is a surprising paucity of information describing fasciotomy technique for the foot. Presented here is such a case of compartment syndrome of the foot requiring urgent fasciotomy. We also present use of a novel closure devise for the fasciotmy wound. A nine year-old boy patient underwent a craniotomy for a dysplastic cerebellar gangliocytoma with sole vascular access consisting of a 21 gauge peripheral foot IV. Massive unilateral lower extremity edema was noted at the conclusion of the case after removal of the sterile drapes. Multiple services including trauma, orthopedics and vascular were consulted for evaluation of foot compartment syndrome but none were capable of foot fasciotomies. The plastic surgery service was consulted and the diagnosis was confirmed by measurements of compartment pressures. Fasciotomies to the dorsum of the foot were emergently performed and an external tissue-expanding/ wound contraction device was utilized to allow for delayed primary closure. These incisions were gradually approximated and a delayed primary closure was accomplished. The patient recovered without permanent sequelae.

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