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Three Part Question

In [adults post fasciotomy for acute compartment syndrome] is [post-operative exercise] beneficial for [improving functional recovery]?

Clinical Scenario

A 55 year old man is admitted to the vascular ward following a fasciotomy and bilateral lower limb embolectomy. He presents with reduced ROM and strength of his ankle and is struggling to weight bear due to pain. Does physiotherapy and exercise improve functional recovery?

Search Strategy

Medline (2/7), CINAHL (1/4), Cochrane (1/28), PubMed (0/79) EMBASE (0/15), via the EBSCO interface Jan 2000- Nov 2020. In addition 2 articles were identified via reference searching from relevant articles and google scholar.
([physiotherapy OR physical therapy OR rehabilitation OR exercise] AND [fasciotomy] AND [compartment syndrome OR acute compartment syndrome) AND [post-operative OR post-surgery]) AND function OR recovery LIMIT to [English AND 2010-2020]

Search Outcome

Altogether a total of 133 articles were found using the search terms, of which 128 were unrelated to the question. However, on review all papers were deemed irrelevant. One indisputable issue was that articles discussed chronic exertional compartment syndrome and subjects selected to take part in trials were frequently from the military or athletes, others did not involve exercise for post-operative treatment. A literature review was identified proposing a 4 stage rehabilitation programme consisted of ROM, stretching, strengthening, and functional exercises.

Comment(s)

It is apparent there is limited published information regarding postoperative management of adults following fasciotomy in the treatment of acute compartment syndrome.

Clinical Bottom Line

There is limited research into best practice for post-operative physiotherapy following fasciotomy for acute compartment syndrome therefore further research needs to be conducted to guide physiotherapy treatment.