Primary closure of fasciotomies has a reduced complication rate following compartment syndrome in the paediatric population

• Published in: International orthopaedics 2024-09, Vol.48 (9), p.2475-2481
• Main Authors: Walker, Lucy C., Mullins, Barry M., Edwards, Caroline, Wadia, Farokh
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Child, Preschool; Compartment Syndromes - diagnosis; Compartment Syndromes - epidemiology; Compartment Syndromes - etiology; Compartment Syndromes - surgery; Fasciotomy - methods; Female; Humans; Infant; Male; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Retrospective Studies; Treatment Outcome
• ISSN: 0341-2695; 1432-5195; 1432-5195
• DOI: 10.1007/s00264-024-06233-1

Purpose Currently no guidance exists within the literature regarding diagnostic criteria or the long-term outcomes for paediatric patients with acute compartment syndrome (ACS). We conducted a retrospective cohort study reviewing all cases of paediatric ACS managed at a single tertiary referral centre with the aim of characterising the factors responsible for the eventual outcomes. Methods The patient cohort was identified retrospectively by interrogating the hospital coding system for all paediatric patients between January 2014 and November 2022. The electronic emergency department, inpatient and operative notes as well as clinic letters for each patient were reviewed and data collected regarding presentation, associated injuries, management and subsequent complications plus length of follow-up. The data was analysed to determine if differences in presentation or management affected long term outcome. Results The final cohort consisted of 34 patients with a mean age of ten years at the time of presentation. The mean time from presentation to fasciotomy was 27.6 h (range 3.0 – 66.6). There was an overall complication rate of 37.5% with a mean follow-up period of 21 months. Patients who had direct closure of their fasciotomy wounds had a significantly lower complications rate and fewer operations compared to those who healed via other wound coverage methods or secondary intention (p