title: Factors associated with persistent sequelae after fasciotomy for acute compartment syndrome.
abstract: OBJECTIVE
  To determine factors associated with persistent sequelae after fasciotomy for acute compartment syndrome.
  
  
  METHODS
  Records of 57 men and 3 women aged 8 to 84 (mean, 31.9) years who underwent fasciotomy of the lower (n=48) or upper (n=12) limbs for acute compartment syndrome following limb trauma were retrospectively reviewed. 58 of the fasciotomies were therapeutic and 2 were prophylactic. The mean follow-up was 3.9 (range, 1-8) years. Patients were assessed through a telephone survey for persistent sequelae (parasthaesia, dysasthaesia, and/or motor weakness), using a scale of one to 4 to indicate asymptomatic, mild, moderate, and severe, respectively. Associations of persistent sequelae with the aetiology, mechanism of injury, site of fasciotomy, time to fasciotomy (from admission to anaesthesia induction), number of operations, method of closure, time to closure, and perioperative complications were assessed.
  
  
  RESULTS
  18 patients were asymptomatic and 42 reported having persistent sequelae including motor weakness (n=26), parasthaesia (n=28), and dysasthaesia (n=30). In terms of severity, these sequelae were mild (n=10), moderate (n=12), or severe (n=20). Persistent sequelae were associated with higher number of operations, post-fasciotomy complications, closures with skin grafting, and increased time to closure.
  
  
  CONCLUSIONS
  To reduce the risk of persistent sequelae after fasciotomy, careful preoperative planning and meticulous perioperative care is needed to avoid multiple operations and post-fasciotomy complications. Patients whose wounds healed by secondary intention showed the best outcome.
authors.affiliation: Department of Trauma and Orthopaedics, Waterford Regional Hospital, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: Dover
authors.forename: Adeel R
authors.initials: AR
authors.lastname: Memon
authors.forename: Hanan
authors.initials: H
authors.lastname: Marafi
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Kelly
authors.forename: John F
authors.initials: JF
authors.lastname: Quinlan
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003161:Compartment Syndromes / Q000209:etiology / Q000601:surgery*; D019299:Decompression, Surgical; D000071938:Fasciotomy; D005260:Female; D005360:Fibula / Q000293:injuries*; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D013978:Tibial Fractures / Q000150:complications; D055815:Young Adult