Long-Term Outcomes of Fasciotomy for Acute Compartment Syndrome After a Fracture of the Tibial Diaphysis. Issue 10 (October 2020)

• Record Type: Journal Article
• Authors: MacKenzie, Samuel A.; Carter, Thomas H.; MacDonald, Deborah; White, Timothy O.; Duckworth, Andrew D.
• Is Part Of: Journal of orthopaedic trauma. Volume 34:Issue 10(2020)
• Publication Date: 2020-10
• Subjects: tibial diaphyseal fractures -- acute compartment syndrome -- complications -- long-term outcomes; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000001786
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objectives: To evaluate the short- and long-term patient-reported outcomes of acute compartment syndrome (ACS) complicating a fracture of the tibial diaphysis. Design: A retrospective review. Setting: Academic orthopaedic trauma center. Patients: We retrospectively identified 559 patients from a trauma database over a 7-year period. Forty-one patients (7.3%) underwent fasciotomies for ACS and were included in the study. A matched cohort of 185 patients who did not develop ACS was used as controls. Intervention: Fasciotomy for ACS. Main Outcome Measurements: The primary short-term outcome measure was the development of complications, including infection, nonunion, and further surgery. The primary long-term outcome measure was the patient-reported EuroQol-5D-3L (EQ-5D). Secondary long-term outcomes included the Oxford Knee Score, the Manchester–Oxford Foot Questionnaire, and satisfaction. Results: There was no significant difference between ACS and non-ACS groups in the overall rate of infection (17% vs. 9.2%, respectively; P = 0.14), deep infection (4.9% vs. 3.8%; P = 0.67), or nonunion (4.9% vs. 7.0%; P = 1.00). There were 206 patients (21 ACS) with long-term outcome data at a mean of 5 years (1–9). There was no significant difference between groups about the EQ-5D ( P = 0.81), the Oxford Knee Score ( P = 0.24), or the Manchester–Oxford Foot Questionnaire ( P = 0.63). Patient satisfaction was reduced in patients who developed ACS (77 vs. 88; P = 0.039). Conclusion: These data suggest that when managed with urgent decompressive fasciotomies, ACS does not seem to have a significant impact on the long-term patient-reported outcome although patient satisfaction is reduced. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. Abstract : Supplemental Digital Content is Available in the Text.