for anyone wondering, I emailed Dr. Giotikas about this as he is my #1 choice right now for internal stryde tibias in the future.
This was my email to him:
Hello Dr. Giotikas,
I have had height dysphoria for a very long time, and would like to get stryde internal tibias done with you in the future. But I have some concerns about the possible complication of acute compartment syndrome, as I know this is a medical emergency.
I have a couple questions that I hope you will be able to answer for me:
1) What preventative measures do you take when doing tibial surgery to make sure compartment syndrome does not occur? Would you consider a concurrent prophylactic compartment release with surgery to prevent compartment syndrome?
2) If compartment syndrome does occur, what would be your plan of action? In your experience of being a surgeon and performing tibia deformity corrections/fracture repairs, etc, what has been the prevalence of compartment syndrome?
Thank you for your time.
This was his response:
Thank you for your interest in Athens Bone & Joint Reconstruction center. Apologies for the delay in our response, the technical part of your questions had to be answered directly by Dr Giotikas. Answering your questions:
1. During surgery we try to minimize bleeding in the calf by using tranexamic acid and by utilizing atraumatic techniqe when making the osteotomy of the bone. We do not routinely perform prophylactic fasciotomy during the index surgery, because fasciotomies might have their own risks. If you are considering to have prophylactic fasciotomies, Dr Giotikas is happy to discuss the matter with you and make a joined decision.
2. The diagnosis of compartment syndrome is straightforward in an alert patient (not sedated or unconscious). The plan of action is to go back to theatre for emergency fasciotomies within the next hour from diagnosis. Closure of fasciotomy wounds (delayed primary or with skin graft) is taking place a few days later, when safe. The incidence of compartment syndrome is reported to be approximately 2-9%, based on studies with mainly tibia fractures.
Compartment syndrome risk and other potential risks and the measures we take to minimize them are thoroughly discussed during the pre-operative consultation with Dr Giotikas.
We hope you found this response useful and we remain at your disposal for any further information ad advice.
Kind regards
Athens BJR secretariat, on behalf of
Dimitrios Giotikas, MD, PhD
Clinical Director
Consultant Trauma & Orthopaedics Surgeon
Just thought I would share!