title: Geographic variation in fasciotomy during operative management of tibia fractures.
abstract: BACKGROUND
  Diagnosis and treatment of acute or impending compartment syndrome (ACS) remains a clinical challenge. ACS is a clinical diagnosis, and may be associated with variation in its definition, as well as individual threshold for fasciotomy. We examined regional and state variation in rates of lower extremity fasciotomy associated with operatively managed tibia fractures.
  
  
  METHODS
  A total of 313,344 surgically treated tibia fractures were identified via Current Procedural Terminology (CPT) codes using PearlDiver, a private-payer medical record database. Data from the PearlDiver database was compared to the National Trauma Data Bank trauma registry data to corroborate calculated fasciotomy rates.
  
  
  RESULTS
  The aggregate United States fasciotomy rate derived from PearlDiver was 2.57%. State fasciotomy rates were wide-ranging (0.03%-11.86%) with an average state rate of 2.22% (n = 47, SD = 2.27).
  
  
  CONCLUSIONS
  There was significant state-to-state variation in the use of fasciotomy during operative management of tibial fractures. Various factors may have contributed to the observed difference of state fasciotomy rates.
  
  
  METHODS
  This is a Level III epidemiological study retrospectively comparing geographic rates of fasciotomy during operative management of tibia fractures.
authors.affiliation: State University of New York at Buffalo, Dept. of Orthopaedics, Erie County Medical Center, Buffalo, NY 14215, United States.
authors.forename: Mark
authors.initials: M
authors.lastname: Anders
authors.affiliation: State University of New York at Buffalo, Dept. of Orthopaedics, Erie County Medical Center, Buffalo, NY 14215, United States.
authors.forename: Christopher
authors.initials: C
authors.lastname: Mutty
authors.affiliation: State University of New York at Buffalo, Dept. of Orthopaedics, Erie County Medical Center, Buffalo, NY 14215, United States.
authors.forename: Allison
authors.initials: A
authors.lastname: Cornwall
keywords: Acute compartment syndrome; Fasciotomy; Geographic variation