Long-Term Outcomes of Fasciotomy for Acute Compartment Syndrome After a Fracture of the Tibial Diaphysis
| Autor: | Andrew D. Duckworth, Thomas H Carter, Deborah MacDonald, Sam A MacKenzie, Timothy O White |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Nonunion MEDLINE Compartment Syndromes Fasciotomy 03 medical and health sciences 0302 clinical medicine Patient satisfaction Medicine Humans Orthopedics and Sports Medicine Retrospective Studies 030222 orthopedics business.industry 030208 emergency & critical care medicine Retrospective cohort study General Medicine Evidence-based medicine medicine.disease Surgery Tibial Fractures Treatment Outcome Diaphyses business Oxford knee score Foot (unit) |
| Zdroj: | Mackenzie, S A, Carter, T, MacDonald, D J, White, T & Duckworth, A 2020, ' LONG-TERM OUTCOMES OF FASCIOTOMY FOR ACUTE COMPARTMENT SYNDROME FOLLOWING A FRACTURE OF THE TIBIAL DIAPHYSIS ', Journal of orthopaedic trauma . https://doi.org/10.1097/BOT.0000000000001786 |
| ISSN: | 1531-2291 |
| Popis: | Objectives To evaluate the short- and long-term patient-reported outcomes of acute compartment syndrome (ACS) complicating a fracture of the tibial diaphysis. Design A retrospective review. Setting Academic orthopaedic trauma center. Patients We retrospectively identified 559 patients from a trauma database over a 7-year period. Forty-one patients (7.3%) underwent fasciotomies for ACS and were included in the study. A matched cohort of 185 patients who did not develop ACS was used as controls. Intervention Fasciotomy for ACS. Main outcome measurements The primary short-term outcome measure was the development of complications, including infection, nonunion, and further surgery. The primary long-term outcome measure was the patient-reported EuroQol-5D-3L (EQ-5D). Secondary long-term outcomes included the Oxford Knee Score, the Manchester-Oxford Foot Questionnaire, and satisfaction. Results There was no significant difference between ACS and non-ACS groups in the overall rate of infection (17% vs. 9.2%, respectively; P = 0.14), deep infection (4.9% vs. 3.8%; P = 0.67), or nonunion (4.9% vs. 7.0%; P = 1.00). There were 206 patients (21 ACS) with long-term outcome data at a mean of 5 years (1-9). There was no significant difference between groups about the EQ-5D (P = 0.81), the Oxford Knee Score (P = 0.24), or the Manchester-Oxford Foot Questionnaire (P = 0.63). Patient satisfaction was reduced in patients who developed ACS (77 vs. 88; P = 0.039). Conclusion These data suggest that when managed with urgent decompressive fasciotomies, ACS does not seem to have a significant impact on the long-term patient-reported outcome although patient satisfaction is reduced. Level of evidence Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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