When performing medical procedures that require a lithotomy position, leaving the patient’s calf free, instead of using a standard well-leg holder, may decrease the patient’s risk of developing acute compartment syndrome.
The syndrome has been widely reported in patients whose legs were positioned in the lithotomy position for prolonged surgical, urologic, or gynaecologic procedures. R. Scott Meyer, MD, and colleagues at the University of California-San Diego Medical Center, in the United States, investigated risk factors that may lead to acute compartment syndrome associated with this type of leg positioning.
The study involved eight healthy volunteers, who were positioned on a fracture table. The patients’ intramuscular pressures were continuously monitored with a slit catheter in all four compartments of the left leg, while the subjects were supine in the hemilithotomy position, with the calf supported, and while they were in the hemilithotomy position, with the heel supported, but the calf free. Their blood pressure was measured intermittently with use of automated pressure cuffs.
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