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Year : 2019  |  Volume : 7  |  Issue : 2  |  Page : 68-71

Acute compartment syndrome of the foot: An unusual case caused by Graston technique

Department of Orthopaedic Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA

Correspondence Address:
Dr. Vince W Lands
801 Ostrum Street, PHPP2, Suite 201, Bethlehem, Pennsylvania 18015
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joas.joas_19_18

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The purpose of this case report is to describe an unusual cause of compartment syndrome of the foot that developed subsequent to the use of Graston technique in a patient who had recently underwent revision total hip arthroplasty (THA). A 60-year-old female presented for orthopedic follow-up care in the office, 10 days postoperatively following an explant of her right hip Prostalac® spacer (DePuy) for previous infection and conversion to right THA (DePuy CORAIL® Hip System) complaining of severe right foot pain, swelling with pressure in foot, paresthesia, and inability to bear weight. The patient had undergone Graston technique for bilateral foot swelling by her home physical therapist. The patient was clinically diagnosed with acute compartment syndrome (ACS) of her right foot and underwent intervention. The treatment consisted of acute fasciotomy of her right foot with vacuum-assisted closure application. Delayed closure was initiated once soft-tissue decompression occurred. Due to acute fasciotomy, ambulation was inhibited and physical therapy delayed. The postoperative course was uneventful following the release of tense compartments, weight bearing was resumed once incisions healed, and the patient was pain free while deep-venous thrombus prophylaxis was continued. No further issues occurred postoperatively, and the patient showed overall clinical improvement. Residual soft swelling can be expected following hip surgery, especially at the caudal end of limbs. Immobilization enhances this engorgement. However, due to the aggressive Graston technique performed by the therapist, the patient developed ACS of the foot. Graston technique has been documented to increase blood flow to treated areas. Early and aggressive intervention should be initiated if ACS is clinically or objectively found, as late detection may have disastrous results.

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