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Case 7: Painful leg

This 33 year old man took an overdose of opiates. He was found collapsed unconscious on the floor lying on his left side approximately 12 hours later.

1. What complication has occurred?

Compartment syndrome of at least the posterior compartment

2. What other clinical settings may result in this condition?

Prolonged ischaemia from any cause. Embolic, thrombotic, traumatic, and associated with lower limb fractures and the resultant swelling.

3. What operation has been performed?

Posterior calf compartment fasciotomy

4. What are the indications this operation?

Confirmed, or in the correct clinical context, the suspicion or predicted occurence of this problem as a prophylactic measure.

Further Reading -Wheeless textbook of orthopaedics --- Compartment Syndrome