title: Acute Traumatic Compartment Syndrome in Pediatric Foot: A Systematic Review and Case Report.
abstract: Acute compartment syndrome of the lower leg and foot is a not widely reported, but serious, potential complication that can develop after fractures, crush injuries, or high-velocity trauma of the lower extremity. Early recognition and treatment are critical in preventing morbidity and permanent complications. Although compartment syndrome of the lower leg and foot has been well-studied and documented in adults, its occurrence in the pediatric population is rare. We performed a systematic review of the published data and present the case of the youngest patient with isolated ACS of the foot. A high index of suspicion is warranted in pediatric patients with a traumatic injury to the lower extremity for compartment syndrome. Inconclusive radiographic findings owing to skeletal immaturity and the inability to verbalize symptoms place young children at high risk of undiagnosed compartment syndrome. Clinicians should have a very low threshold for fasciotomy to prevent long-term sequelae associated with undiagnosed compartment syndrome.
authors.affiliation: Site Director, Foot and Ankle Surgery Residency Program, Postgraduate Year 3, Department of Orthopaedic Surgery, Kaiser Permanente South Sacramento Medical Center, South Sacramento, CA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Wallin
authors.affiliation: Director, Graduate and Undergraduate Medical Education, Kaiser Permanente South Sacramento Medical Center, South Sacramento, CA.
authors.forename: Hienvu
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: Chief, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Kaiser Permanente South Sacramento Medical Center, South Sacramento, CA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Russell
authors.affiliation: Assistant Director, Graduate and Undergraduate Medical Education, Kaiser Permanente South Sacramento Medical Center, South Sacramento, CA. Electronic address: dkleesd@yahoo.com.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Lee
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D003161:Compartment Syndromes / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D000071576:Crush Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D000071938:Fasciotomy / Q000379:methods*; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000293:injuries*; D011859:Radiography / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
keywords: 4; compartment syndrome; fasciotomy; foot; pediatrics; trauma