Injury patterns causing isolated foot compartment syndrome.
BACKGROUND
The true incidence and primary predictors of foot compartment syndrome remain controversial. Our aim was to better define the overall incidence of foot compartment syndrome in relation to the frequency and location of various foot injuries. We hypothesized that (1) the incidence would increase in proportion to the number of anatomic locations of injury, (2) the incidence would be higher in association with hindfoot and crush injuries compared with any other injury categories, and (3) not only would the incidence associated with calcaneal fractures be lower than the often quoted 10% but foot compartment syndrome would also be fairly uncommon after such fractures.


METHODS
The National Trauma Data Bank was used to identify patients who had undergone a fasciotomy for the treatment of isolated foot compartment syndrome. Strict inclusion and exclusion criteria were used to identify only patients with foot injuries who had undergone fasciotomy for foot compartment syndrome.


RESULTS
Three hundred and sixty-four patients with an isolated foot compartment syndrome were identified. The highest incidence of foot compartment syndrome was seen in association with a crush mechanism combined with a forefoot injury (18%, nineteen of 106), followed by an isolated crush injury (14%, twenty-three of 162). Only 1% (thirty-two) of 2481 patients with an isolated calcaneal fracture underwent fasciotomy. An increase in the number of anatomic locations of injury did not appear to correspond to an increased incidence of foot compartment syndrome.


CONCLUSIONS
Our results demonstrate that injuries involving a crush mechanism, either in isolation or in combination with a forefoot injury, should raise suspicion about the possibility that a foot compartment syndrome will develop.
Department of Orthopaedics, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA. nthakur79@gmail.com
Nikhil A
NA
Thakur
Matthew
M
McDonnell
Christopher J
CJ
Got
Nicole
N
Arcand
Kevin F
KF
Spratt
Christopher W
CW
DiGiovanni
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003161:Compartment Syndromes / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D003444:Crush Syndrome / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D016208:Databases, Factual; D019299:Decompression, Surgical / Q000379:methods; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D005528:Foot; D018409:Foot Injuries / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D018570:Risk Assessment; D017678:Sex Distribution; D016896:Treatment Outcome; D055815:Young Adult