Acute compartment syndrome in the absence of fracture.
OBJECTIVE
To determine if there are differences in demographics, referral patterns, and operative findings between patients with and without a fracture who develop an acute compartment syndrome.


METHODS
Retrospective cohort.


METHODS
Orthopaedic trauma unit, university teaching hospital.


METHODS
This study examines 164 cases of acute compartment syndrome over an 8-year period. Of these, 13 patients had a diagnosis of crush syndrome and are excluded from this study. The remaining 38 cases with no fracture form the basis for this study.


METHODS
Patient demographics, referral patterns, and operative findings were compared for the "fracture" and "no fracture" groups.


RESULTS
Patients who had acute compartment syndrome in the absence of fracture were older (P < 0.05) and had significantly more comorbidities (P < 0.001) than those with a fracture. Cases without a fracture had a significantly greater mean delay to fasciotomy of 12.4 hours (P < 0.05) compared to those with a fracture. At fasciotomy, 20% of patients without a fracture had muscle necrosis requiring debridement compared to 8% for patients with a fracture (P < 0.05).


CONCLUSIONS
This study demonstrates that muscle necrosis is more commonly found in acute compartment syndrome in the absence of a fracture than in those with a fracture. Referral of swollen limbs without fracture for an orthopaedic opinion should not be delayed.
Hope
M J
MJ
Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Old Dalkeith Road, Edinburgh EH16 4SU, Scotland, UK.
McQueen
M M
MM
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D003161:Compartment Syndromes / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003646:Debridement; D000071938:Fasciotomy; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D009336:Necrosis; D019637:Orthopedic Procedures / Q000379:methods; D012017:Referral and Consultation; D012189:Retrospective Studies; D016896:Treatment Outcome