title: Compartment syndrome in infants and toddlers.
abstract: OBJECTIVE
  To study the cause, diagnosis, treatment and outcome of acute compartment syndrome in infants and toddlers aged <3 years.
  
  
  METHODS
  Fifteen patients aged <3 years with acute compartment syndrome were identified from two large pediatric trauma centers over a fifteen-year period. All children underwent fasciotomy. The mechanism of injury, time of injury, time to diagnosis, compartment pressures, time to fasciotomy, and outcome at the time of the latest follow-up were recorded.
  
  
  RESULTS
  Nine (60 %) of fifteen patients developed compartment syndrome secondary to trauma, four (4/15, 27 %) due to infection, and two (2/15, 13 %) due to intravenous infiltration. The average time from injury or hospital admission to fasciotomy was 31.8 h (range 2.9-136.3 h). In general, the functional outcome was excellent at the latest follow-up with thirteen (13/15, 87 %) patients having an excellent outcome. No cases of Volkmann's ischemia were noted at the time of fasciotomy, even when performed as late as 5 days after injury.
  
  
  CONCLUSIONS
  Compared to the general pediatric population, the diagnosis of compartment syndrome in infants and toddlers may be further delayed, i.e., >24 h after injury. Despite delays in diagnosis and time to treatment, the present study shows that outcomes in infants and toddlers remain favorable even when fasciotomy is performed 48-72 h after injury.
  
  
  METHODS
  Case series, level IV.
authors.affiliation: Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #69, Los Angeles, CA, 90027, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Broom
authors.affiliation: Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #69, Los Angeles, CA, 90027, USA.
authors.forename: Mathew D
authors.initials: MD
authors.lastname: Schur
authors.affiliation: Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, USA.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Arkader
authors.affiliation: Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, USA.
authors.forename: John
authors.initials: J
authors.lastname: Flynn
authors.affiliation: Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Gornitzky
authors.affiliation: Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #69, Los Angeles, CA, 90027, USA. PChoi@chla.usc.edu.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Choi
keywords: Compartment syndrome; Fasciotomy; IV infiltration; Infection; Pediatric