ArticleOrthopedic reviews2026
Late reconstruction of missed compartment syndrome after tibial plateau fixation surgery: A case report with 6 years of follow-up.
Article in Orthopedic reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute compartment syndrome of the leg is a well-documented orthopedic emergency; however, cases missed following open reduction and internal fixation (ORIF) of tibial plateau fractures are rarely reported. Delayed diagnosis can lead to severe sequelae such as foot deformity and functional impairment, posing significant challenges for rehabilitation. Case Presentation: We report the case of a 41-year-old female presenting with chronic sequelae of missed compartment syndrome 6 months after ORIF for a Schatzker II tibial plateau fracture. Clinical presentation included progressive equinus deformity, ankle stiffness, loss of active dorsiflexion, sensory disturbance in the anterolateral leg and dorsum of the foot, and an inability to maintain a plantigrade foot during ambulation. The patient underwent a comprehensive late reconstruction strategy, comprising percutaneous Achilles tendon lengthening, common peroneal nerve release, deep flexor tendon release, and the Bridle procedure to restore active dorsiflexion. Results: At the 6-year follow-up, the patient achieved a plantigrade foot, improved gait mechanics without equinus deformity, restoration of active dorsiflexion, and sensory recovery. The AOFAS Ankle-Hindfoot Scale score was 73/100, indicating good functional recovery. Conclusion: Missed compartment syndrome after ORIF of tibial plateau fractures can cause severe functional impairment if not recognized early. In chronic cases, a personalized reconstruction strategy combining tendon lengthening, nerve release, and tendon transfer can provide sustained functional improvement, even when intervention is delayed.
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