This case involves a 24-year-old male who has a past medical history significant for numerous knee injuries requiring surgical reconstruction. The third attempt at surgical repair of his left knee was complicated post-operatively in that during the immediate recovery phase the patient complained of severe pain in the contralateral leg. The patient was rushed back to the OR for an emergent fasciotomy. Three days later when the reassessment of the wound was conducted, it was determined that a vast majority of the muscle was not viable and required removal. It is documented that the vascular surgeon present at the second exploration stated that it seems that the initial decompression procedure may have been inadequate and the result was that the patient came out with severe compartment syndrome in his right leg such that he has little or no use of the limb.
Question(s) For Expert Witness
- 1. Was the patient’s condition possibly caused by improper positioning of the patient during the knee surgery?
- 2. Furthermore, was the salvage procedure done to manage the compartment syndrome within the standard of care?
Expert Witness Response E-000594
I believe this case may hinge on the vascular surgeon’s reasons for saying the initial fascial decompression was inadequate. Wounds with dying tissue evolve even after a fasciotomy is done and should be followed closely as I have seen many cases in my career take a turn for the worst at the drop of a dime. It is essential to keep a close watch in the post operative period from day 0 to day 4, before considering the procedure to be a complete success.