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International Orthopaedics

, Volume 43, Issue 6, pp 1465–1472 | Cite as

Acute compartment syndrome in patients undergoing fasciotomy of the forearm and the leg

  • Dafang ZhangEmail author
  • Matthew Tarabochia
  • Stein J. Janssen
  • David Ring
  • Neal Chen
Original Paper
  • 114 Downloads

Abstract

Purposes

The primary objective of this study is to compare the likelihood of acute compartment syndrome in the leg versus the forearm in patients who undergo fasciotomy for a clinical diagnosis of suspected acute compartment syndrome. The secondary objective is to identify factors associated with higher likelihood of acute compartment syndrome or with the use of split-thickness skin graft in these patients.

Methods

We identified 449 patients diagnosed with suspected acute compartment syndrome of 468 legs and 119 patients diagnosed with suspected acute compartment syndrome of 119 forearms, treated with fasciotomy, from January 2000 to June 2015. Patients clinically diagnosed with suspected acute compartment syndrome were scored for likelihood of acute compartment syndrome based on muscle appearance, time to closure, neurologic deficit at final follow-up, and contracture at final follow-up.

Results

There was no difference in likelihood of acute compartment syndrome between the leg and the forearm, with about 70% having relatively high likelihood. Forearm fasciotomy was associated with documentation of poorer muscle appearance (p = 0.01) and contracture (p < 0.001) compared with leg fasciotomy. Multivariable logistic regression analyses showed that compartment pressure measurement (p = 0.01) was associated with higher likelihood of acute compartment syndrome in legs and that male sex (p = 0.001) and non-vascular mechanism of injury (p = 0.02) were associated with split-thickness skin graft in legs.

Conclusions

The likelihood and severity of acute compartment syndrome are comparable in the leg and the forearm.

Keywords

Acute compartment syndrome Diagnosis Forearm Leg Split-thickness skin graft 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryMassachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Department of General Surgery, OLVGAmsterdamThe Netherlands
  4. 4.Dell Medical SchoolUniversity of TexasAustinUSA

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