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Predictors of acute compartment syndrome in patients with tibial fractures: a meta-analysis

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A Letter to the Editor to this article was published on 02 March 2023

Abstract

Study design

This is the first meta-analysis focusing on the risk factors related to ACS after tibial fractures.

Background

Acute compartment syndrome (ACS) is a serious complication that affects 2–9% of tibial fracture patients. It is importance of identifying the predictors of ACS in patients with tibial fractures.

Questions/purposes

We performed a meta-analysis to identify the risk factors of ACS after tibial fracture.

Methods

We searched articles in the English databases, such as PubMed, Embase, and the Cochrane Library and the Chinese databases including CNKI and WAN FANG. We collected data related to ACS from included studies and analyzed data by RevMan 5.3 and STATA 12.0.

Results

The rate of ACS was 2.7% (10,708 of 398,414 patients) from 16 included articles. Our data showed that younger age (p < 0.00001, OR =  − 7.93, 95% CI [− 9.34, − 6.25]), male patients (p < 0.00001, OR = 2.17, 95% CI [2.07, 2.28]), patients without a history of hypertension (p < 0.00001, OR = 0.69, 95% CI [0.64, 0.74]), with a history of smoking (p < 0.00001, OR = 1.38, 95% CI [1.30, 1.46]), and patients with fibular fractures (p = 0.001, OR = 2.68, 95% CI [1.47, 4.87]), closed fracture (p = 0.02, OR = 0.86, 95% CI [0.75, 0.98]), high-energy injury (p = 0.003, OR = 0.37, 95% CI [0.19, 0.71]), motorized accident (p = 0.0009, OR = 0.41, 95% CI [0.24, 0.69]), proximal fracture, AO-C-type fracture, comminuted fracture, and Schatzker grade IV–VI fracture were associated with the development of ACS. Additionally, femoral displacement ratio and tibial widening ratio in the ACS groups were significantly higher than in the non-ACS group.

Conclusion

Many factors were found to be associated with the development of ACS following tibial fractures. We provide references when we met the above characteristics of patients to rapidly identify and highly concern ACS.

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Data availability

Not applicable.

Abbreviations

ACS:

Acute compartment syndrome

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Funding

Support was provided by the 2019 Government-Funded Clinical Medicine Outstanding Talent Training Project, Natural Science Foundation of Hebei (H2020206193).

Author information

Author notes

  1. Tao Wang, Junfei Guo and Yubin Long contributed equally.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China

    Tao Wang, Junfei Guo, Yubin Long & Zhiyong Hou

  2. Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, People’s Republic of China

    Tao Wang, Junfei Guo, Yubin Long & Zhiyong Hou

  3. NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, China

    Zhiyong Hou

Authors
  1. Tao Wang
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  2. Junfei Guo
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Contributions

T. W., J. F. G., and Y. B. L. were responsible for the study concept and writing the article. Z. Y. H. was responsible for reviewing and writing the article.

Corresponding author

Correspondence to Zhiyong Hou.

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Ethics approval and consent to participate

The study was approved by the Institutional Review Board of the Third Hospital of Hebei Medical University before data collection and analysis. There is no need to write informed consent forms from patients because this is a meta-analysis study.

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Yes.

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The authors declare no competing interests.

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Wang, T., Guo, J., Long, Y. et al. Predictors of acute compartment syndrome in patients with tibial fractures: a meta-analysis. International Orthopaedics (SICOT) 47, 51–65 (2023). https://doi.org/10.1007/s00264-022-05643-3

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  • DOI: https://doi.org/10.1007/s00264-022-05643-3

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