Compartment syndrome. A complication of intravenous regional anesthesia in the reduction of lower leg shaft fractures.

Forty-one consecutive patients who had closed reduction of closed lower leg shaft fractures under an intravenous regional anesthetic are reviewed for the complication of compartment syndrome. Four patients were graded as having mild compartment syndrome, two as moderate, and five as severe, giving an overall rate of 27%. This was compared with a control group of 39 consecutive patients who also underwent closed reduction of closed lower leg shaft fractures, but under general anesthesia or intravenous analgesia alone rather than an intravenous regional anesthetic. In the control group, three patients were graded as having mild compartment syndrome, and two as severe, giving an overall complication rate of 13%. The authors feel that the use of the thigh tourniquet with the intravenous regional anesthetic technique increases the frequency of compartment syndrome as a complication in lower leg fractures.