title: Acute compartment syndrome of the forearm.
abstract: BACKGROUND
  The aims of this study were to document our experience with acute forearm compartment syndrome and to determine the risk factors for the need for split-thickness skin-grafting and the development of complications after fasciotomy.
  
  
  METHODS
  We identified from our trauma database all patients who underwent fasciotomy for an acute forearm compartment syndrome over a twenty-two-year period. Diagnosis was made with use of clinical signs in all patients, with compartment pressure monitoring used as a diagnostic adjunct in some patients. Outcome measures were the use of split-thickness skin grafts and the identification of complications following forearm fasciotomy.
  
  
  RESULTS
  There were ninety patients in the study cohort, with a mean age of thirty-three years (range, thirteen to eighty-one years) and a significant male predominance (eighty-two patients; p < 0.001). A fracture of the radius or ulna, or both, was seen in sixty-two patients (69%), with soft-tissue injuries as the causative factor in twenty-eight (31%). The median time to fasciotomy was twelve hours (range, two to seventy-two hours). Risk factors for requiring split-thickness skin-grafting were younger age and a crush injury (p < 0.05 for both). Risk factors for the development of complications were a delay in fasciotomy of more than six hours (p = 0.018) and preoperative motor symptoms, which approached significance (p = 0.068).
  
  
  CONCLUSIONS
  Forearm compartment syndrome requiring fasciotomy predominantly affects males and can occur following either a fracture or soft-tissue injury. Age is an important predictor of undergoing split-thickness skin-grafting for wound closure. Complications occur in a third of patients and are associated with an increasing time from injury to fasciotomy.
authors.affiliation: Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SU, United Kingdom. andrew.duckworth@yahoo.co.uk
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Duckworth
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Mitchell
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Molyneux
authors.forename: Timothy O
authors.initials: TO
authors.lastname: White
authors.forename: Charles M
authors.initials: CM
authors.lastname: Court-Brown
authors.forename: Margaret M
authors.initials: MM
authors.lastname: McQueen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003161:Compartment Syndromes / Q000209:etiology* / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D005542:Forearm; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D016038:Skin Transplantation; D016896:Treatment Outcome