Compartment Syndrome in Children With a Supracondylar Fracture: Not Everyone has Risk Factors.

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  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8807705 Publication Model: Print Cited Medium: Internet ISSN: 1531-2291 (Electronic) Linking ISSN: 08905339 NLM ISO Abbreviation: J Orthop Trauma Subsets: MEDLINE
    • Publication Information:
      Publication: Hagerstown, MD : Lippincott Williams & Wilkins
      Original Publication: [New York, N.Y.] : Raven Press, [c1987-
    • Subject Terms:
      Compartment Syndromes*/diagnosis ; Compartment Syndromes*/epidemiology ; Compartment Syndromes*/etiology ; Humeral Fractures*/complications ; Humeral Fractures*/epidemiology ; Humeral Fractures*/surgery; Child ; Humans ; Male ; Pennsylvania/epidemiology ; Retrospective Studies ; Risk Factors ; Treatment Outcome
    • Abstract:
      Objectives: To clarify the incidence, associated conditions, and timing of fasciotomy for compartment syndrome (CS) in children with a supracondylar (SC) fracture of the humerus.
      Design: A retrospective trauma system database study.
      Setting: Accredited trauma centers in Pennsylvania.
      Patients: A statewide trauma database was searched for children 2-13 years of age admitted with a SC fracture between January 2001 and December 2015. Four thousand three hundred eight children met inclusion criteria.
      Intervention: Treatment of a SC fracture.
      Main Outcome Measurement: Diagnosis of CS/performance of a fasciotomy.
      Results: During the study period, 21 (0.49%) children admitted with a SC fracture of the humerus were treated with fasciotomy. CS/fasciotomy was more likely in males (P = 0.031), those with a nerve injury (P = 0.049), and/or ipsilateral forearm fracture (P < 0.001). Vascular procedure, performed in 18 (0.42%) children, was strongly associated with CS/fasciotomy (P < 0.001). Closed reduction and fixation of a forearm fracture was associated with CS (P = 0.007). Timing of SC fracture treatment did not influence outcome. Fasciotomy was performed subsequent to reduction in 13 subjects; mean interval between procedures was 23.4 hours (r = 4.5-51.3).
      Conclusions: Risk factors for CS exist; however, they are not required for the condition to develop. CS may develop subsequent to admission and/or SC fracture treatment. In timing of operative management and hospitalization, the results support contemporary practice.
      Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
      Competing Interests: The authors report no conflict of interest.
      (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
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    • Publication Date:
      Date Created: 20201130 Date Completed: 20210806 Latest Revision: 20230828
    • Publication Date:
      20230830
    • Accession Number:
      10.1097/BOT.0000000000002030
    • Accession Number:
      33252445