Compartment syndrome following intramedullary fixation of pediatric forearm fractures

• Published in: Journal of pediatric orthopaedics Vol. 24; no. 4; p. 370
• Main Authors: Yuan, Philip S, Pring, Maya E, Gaynor, Tracey P, Mubarak, Scott J, Newton, Peter O
• Format: Journal Article
• Language: English
• Published: United States 01.07.2004
• Subjects: Adolescent; Child; Child, Preschool; Compartment Syndromes - etiology; Debridement; Female; Fracture Fixation, Intramedullary - adverse effects; Fractures, Closed - surgery; Humans; Male; Radius Fractures - surgery; Risk Factors; Ulna Fractures - surgery
• ISSN: 0271-6798; 1539-2570
• DOI: 10.1097/00004694-200407000-00005

This study was designed to evaluate the incidence of compartment syndrome (CS) resulting from the treatment of both-bone forearm fractures in children. A retrospective analysis of 285 consecutive children who presented with both-bone forearm fractures was performed. Of 235 closed injuries, 205 were treated with closed reduction and casting; none of these patients developed CS. Thirty of the closed injuries were treated with closed reduction and intramedullary fixation; three of these patients (10%) developed CS. Fifty patients sustained open fractures and were treated with debridement and open reduction with intramedullary pinning; CS developed in three of these patients (6%). The eighty patients treated with intramedullary fixation had an increased incidence of CS compared with the 205 patients treated with closed reduction and casting (P < 0.001). Within the group of patients who had surgery, patients with longer operative times and more use of intraoperative fluoroscopy were at higher risk of developing CS.