Compartment syndrome as a complication of the prolonged use of the Lloyd‐Davies position

Abstract

SummaryCompartment syndrome in the legs is a rare complication of the prolonged use of the lithotomy position. We report two cases of compartment syndrome developing as a complication of the prolonged use of the Lloyd‐Davies position. Both patients received combined general and epidural anaesthesia and postoperative epidural analgesia. The diagnosis was delayed in the first case, resulting in the avoidable complications of renal failure and permanent neuromuscular dysfunction.

Compartment Syndrome of the Lower Extremity

“…The combined effects of direct compression, compressive circumferential bindings or stockings, sequential inflatable devices, and relative elevation of the limb contribute to increase compartment pressure, decrease compartment volume, and decrease blood flow. The combination of these factors in the end may lead to the formation of an acute compartment syndrome [79,82].…”

Acute Anterior Thigh Compartment Syndrome Revisited: A Case Report and Review of Literature

“…The most commonly used diagnostic piece of equipment is the hand held monitoring system. Acute compartment syndrome has been described in literature as a result of direct trauma in several contact sports [8][9][10][11][12][13] or as a result of other causes including burns [14], positioning during surgery [15] and ischemic reperfusion injury [16]. Non traumatic acute anterior thigh compartment syndrome, on the other hand, is a rather rare phenomenon and has been scarcely reported in literature.…”

Diagnosing Acute Compartment Syndrome

“…16 It typically follows traumatic injury, but may also occur after ischaemic reperfusion injuries, 17 burns, 18 prolonged limb compression after drug overdose 19 or poor positioning during surgery. [20][21][22][23][24] Furthermore, subclinical compartment syndromes may explain the occurrence of a variety of postoperative disabilities which have been identified after the treatment of fractures of long bones using intramedullary nails. 25 Approximately 40% of all acute compartment syndromes occur after fractures of the tibial shaft 26 with an incidence in the range of 1% to 10%.…”