Risk factors for acute compartment syndrome in one thousand one hundred and forty seven diaphyseal tibia fractures

• Published in: International orthopaedics Vol. 48; no. 8; pp. 2211 - 2216
• Main Authors: Strain, Ritchie, Giannoudis, Peter
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2024
• Subjects: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Body Mass Index; Cohort Studies; Compartment Syndromes - diagnosis; Compartment Syndromes - epidemiology; Compartment Syndromes - etiology; Compartment Syndromes - surgery; Diaphyses - injuries; Female; Fracture Fixation, Intramedullary - adverse effects; Fracture Fixation, Intramedullary - methods; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Original Paper; Orthopedics; Retrospective Studies; Risk Factors; Tibial Fractures - complications; Tibial Fractures - epidemiology; Tibial Fractures - surgery; Young Adult; Acute compartment syndrome; Trauma; Risk factors; Tibia fracture
• ISSN: 0341-2695; 1432-5195; 1432-5195
• DOI: 10.1007/s00264-024-06235-z

Purpose Acute compartment syndrome (ACS) remains a devastating complication of orthopaedic trauma. The tibial diaphysis is especially implicated in the development of ACS, both at the time of injury and after operative management. Identification of risk factors for ACS for these distinct scenarios has been investigated in a large cohort of patients. Methods This is a retrospective cohort study of all adults (age 18 years and older) presenting to a level 1 trauma centre with a diaphyseal tibia fracture. ACS was determined by a combination of clinical signs and symptoms and compartmental pressure monitoring. Potential risk factors were subject to univariate analysis with significant variables undergoing binary logistic regression analysis. Results 1147 tibial diaphyseal fractures over a twelve year period were studied. Age, multifragmented fracture pattern, male gender, high energy mechanism and intra- articular extension all showed a statistically significant association for ACS. Increasing body mass index (BMI) and treatment with an intramedullary nail favoured development of ACS post-operatively. Conclusion Risk factors for the development of ACS specifically in tibial diaphyseal fractures have been highlighted. Patients managed with IMN or high BMI may warrant particular observation following operative intervention.