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Increase in infection, nonunion found after fasciotomy for compartment syndrome
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Patients with tibial shaft or plateau fractures with compartment syndrome who underwent fasciotomy had a significant increase in infection and nonunion compared to patients without compartment syndrome and did not undergo fasciotomy, according to results.
Researchers stratified 184 patients into the following four groups: patients with tibial plateau fracture with compartment syndrome (group 1, n=23); patients with tibial plateau fracture without compartment syndrome (group 2, n=69); patients with tibial shaft fracture with compartment syndrome (group 3, n=23); and patients with tibial shaft fracture without compartment syndrome (group 4, n=69). Researchers treated patients who had compartment syndrome with a two-incision four-compartment fasciotomy. Main outcome measures included time to union and the incidence of deep infection, nonunion and delayed union.
Results showed groups 1 and 3 had an average time to union of 26.8 weeks vs. 21.5 weeks for groups 2 and 4. Researchers found 20% of patients in groups 1 and 3 developed nonunion and the same percentage of patients in those groups developed deep infection. In groups 2 and 4, 5% of patients had nonunion and 4% of patients had deep infection.
Group 1 had a significant increase in infection compared with group 2. Results also showed group 3 had a significant increase in nonunion compared with group 4.
Overall, 46% of patients who underwent fasciotomy were smokers vs. 20% of patients who smoked and did not undergo fasciotomy, researchers noted. However, following binary regression analysis that controlled for smoking, researchers found all statistical results remained similar for rates of deep infection, delayed union and time to union. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.
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