scholarly journals Predictors of acute compartment syndrome of the lower leg in adults following tibial plateau fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiangtian Deng ◽  
Hongzhi Hu ◽  
Zhipeng Ye ◽  
Jian Zhu ◽  
Yiran Zhang ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Compartment Syndrome ◽  
Tibial Plateau ◽  
Lower Leg ◽  
Tibial Plateau Fractures ◽  
Acute Compartment Syndrome ◽  
Patient Age ◽  
Patient Âgé ◽  
Type Fracture ◽  
Younger Patient

Abstract Background Acute compartment syndrome (ACS) is an underestimated complication following tibial plateau fractures. Understanding predictors of ACS in the lower leg after a fracture of the tibial plateau may guide earlier diagnosis and promptly decompressed by surgical fasciotomy. To date, however, there are few large-scale sample literatures to investigate the predictors of it. The purpose of our study was to evaluate the prevalence rate of ACS associated with tibial plateau fractures and identified any such predictors with the development of ACS. Materials and methods From January 2015 to January 2020, a total of 1119 consecutive patients (1119 fractures) including 703 males and 416 females with an average age of 40.7 years (18 to 80 years) in tibial plateau fractures who presented to a university-affiliated hospital with level-I trauma center were included. The presence of ACS and associated predictors were collected from patients’ electronic medical records. Associated predictors included gender, age, fracture pattern (open or closed), mechanisms of injury, fracture classification, and underlying disease. Univariate and multivariate logistical regression analyses were performed to identify the predictors of the development of ACS following tibial plateau fractures. Results Of the 1119 fractures of the tibial plateau, 35 (3.1%) developed an acute compartment syndrome. On multivariate analysis, only younger patient age (odds ratio (OR) 2.57; 95% confidence interval (CI), 1.26 to 6.31; P = 0.003), and Schatzker VI type fracture (OR 5.78; 95% confidence interval (CI), 1.78 to 54.34; P = 0.021) were significantly associated with the development of ACS. Other variables did not reach statistical significance. Conclusion Younger patient age and Schatzker VI type fracture were predictors of ACS of the lower leg in adults following tibial plateau fractures. Further studies in the prospective study are still needed to identify the potential risk factors associated with ACS in tibial plateau fractures.

scholarly journals Does the shoe-lace technique aid direct closure of fasciotomy wounds after acute compartment syndrome of the lower leg? a retrospective case-control study

2021 ◽  
pp. 145749692110196
Author(s):  
P. Suomalainen ◽  
T.-K. Pakarinen ◽  
I. Pajamäki ◽  
M. K. Laitinen ◽  
H.-J. Laine ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Outcome Measurement ◽  
Controlled Trial ◽  
Lower Leg ◽  
Conventional Technique ◽  
Tibia Fracture ◽  
Acute Compartment Syndrome ◽  
Retrospective Case ◽  
Direct Closure ◽  
Patient Database

Background & aim: Tibia fractures are relatively common injuries that are accompanied with acute compartment syndrome in approximately 2% to 20% of cases. Although the shoe-lace technique, where vessel loops are threaded in a crisscross fashion and tightened daily, has been widely used, no studies have compared the shoe-lace technique with the conventional one. The aim of this study was to compare the shoe-lace technique with the conventional technique. Materials and Methods: We identified 359 consecutive patients with intramedullary nailed tibia fracture and complete medical records including outpatient data between April 2007 and April 2015 from electronic patient database of our institute. The use of the shoe-lace technique was compared to conventional one (in which wounds were first left open with moist dressings). Main outcome measurement is direct closure of fasciotomy wounds. Results: From 359 consecutive patients with intramedullary nailed tibia fracture, fasciotomy was performed on 68 (19%) patients. Of these, the shoe-lace technique was used in 47 (69%) patients while in 21 (31%) patients, the shoe-lace technique was not applied. Side-to-side approximation was successful in 36 patients (77%) in the shoe-lace+ group and 7 patients (33%) in the shoe-lace– group (p = 0.002). Conclusion: The main finding of our comparative study was that the shoe-lace technique seems to ease direct closure of lower leg fasciotomy wounds, and thus reduces the frequency of free skin grafts. Our finding needs to be confirmed in a high-quality randomized controlled trial.

scholarly journals Compartment Syndrome following Open Femoral Fracture with an Isolated Femoral Vein Injury Treated with Acute Repair

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
David Walmsley ◽  
Terry Axelrod ◽  
Sebastian Rodriguez-Elizalde
Keyword(s):  
Risk Factor ◽  
Compartment Syndrome ◽  
Femoral Fracture ◽  
Femur Fracture ◽  
Femoral Vein ◽  
Lower Leg ◽  
Acute Compartment Syndrome ◽  
Therapeutic Anticoagulation ◽  
Vein Injury ◽  
Grade Iii

Acute compartment syndrome is a surgical emergency and its diagnosis is more difficult in obtunded or insensate patients. We present the case of a 34-year-old woman who sustained a Gustilo-Anderson grade III open midshaft femur fracture with an isolated femoral vein injury treated with direct repair. She developed lower leg compartment syndrome at 48 hours postoperatively, necessitating fasciotomies. She was subsequently found to have a DVT in her femoral vein at the level of the repair and was started on therapeutic anticoagulation. This case highlights the importance of recognition of isolated venous injuries in a trauma setting as a risk factor for developing compartment syndrome.

Differences between primary and secondary definitive osteosynthesis for fractures of the lower leg with concomitant acute compartment syndrome

2019 ◽  
Vol 46 (5) ◽  
pp. 1167-1173
Author(s):  
Christopher Ull ◽  
Oliver Jansen ◽  
Dominik Seybold ◽  
Matthias Königshausen ◽  
Thomas Armin Schildhauer ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Lower Leg ◽  
Acute Compartment Syndrome

Age and dressing type as independent predictors of post-operative infection in patients with acute compartment syndrome of the lower leg

2017 ◽  
Vol 41 (12) ◽  
pp. 2591-2596 ◽  
Author(s):  
Mark E. Hake ◽  
Jordan Etscheidt ◽  
Vivek P. Chadayammuri ◽  
Jacob M. Kirsch ◽  
Cyril Mauffrey
Keyword(s):  
Compartment Syndrome ◽  
Lower Leg ◽  
Acute Compartment Syndrome

scholarly journals Acute compartment syndrome of the lower leg causing cardiac arrest after resection of the right external iliac vein for autologous graft: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Koji Hoshino ◽  
Toru Nakamura ◽  
Mineji Hayakawa ◽  
Yusuke Itosu ◽  
Hitoshi Saito ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Portal Vein ◽  
Compartment Syndrome ◽  
Iliac Vein ◽  
Lower Leg ◽  
Acute Compartment Syndrome ◽  
External Iliac Vein ◽  
Portal Vein Reconstruction ◽  
Vein Resection ◽  
The Right

Abstract Background The right external iliac vein (REIV) is often used for portal vein reconstruction in patients undergoing pancreatoduodenectomy with portal-superior mesenteric vein resection. We report a case of cardiac arrest caused by acute lower leg compartment syndrome as a result of REIV resection. Case presentation A 53-year-old man underwent pancreatoduodenectomy with portal vein resection. Hyperkalemia progressed during surgery due to intestinal reperfusion injury, which caused recurrent ventricular arrhythmia required for cardio-pulmonary resuscitation. The surgery was discontinued after resuscitation, and portal vein reconstruction using the REIV was performed 2 days post-operatively. Acute compartment syndrome was diagnosed immediately following the surgery. Hyperkalemia progressed, causing pulseless ventricular tachycardia. Emergent fasciotomy was performed, but right leg dysfunction persisted after discharge. Conclusion REIV resection can cause lower-extremity acute compartment syndrome. The status, including intracompartmental pressure, of the lower extremity should be carefully observed after REIV resection during and after surgery.

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