Epidemiology, treatment and outcome after compartment syndrome of the thigh in 69 cases - Experiences from a level I trauma centre

Injury. 2019 Jun;50(6):1242-1246. doi: 10.1016/j.injury.2019.04.001. Epub 2019 Apr 5.

Abstract

Background: Compartment syndrome of the thigh (CST) is a rare condition, and its delayed diagnosis and therapy may lead to devastating adverse effects. Thus, the aim of this study was to present the amassed clinical experiences, regarding diagnosis and treatment of CST at a level I trauma centre.

Materials and methods: The database was reviewed for all patients with a manifest CST treated surgically between 1995 and 2014.

Results: 69 patients (61 males and 8 females) met the inclusion criteria, with a mean age of 42.9 years (range: 11-87 years). Forty-four patients (64%) presented with an isolated CST. There was a significant association between complication rates and high impact vs. blunt trauma (12/32, 38% vs. 0/20, 0%; p = 0.0022; Fisher's exact test). The number of surgeries in patients with a concomitant femur fracture was significantly increased (in mean: 2.8 vs. 4.9 surgical interventions; p < 0.001; U test).

Conclusion: Patients after high impact trauma showed the highest complication rate. Concomitant femur fractures were associated with an increased number of surgical interventions. The synopsis of trauma mechanism, clinical presentation, age, anticoagulation status and clinical experience of the trauma surgeon seem to be the best tools to correctly diagnose CST.

Keywords: Compartment syndrome of the thigh; Complications; Diagnostics; Epidemiology; Treatment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Austria / epidemiology
  • Child
  • Compartment Syndromes / diagnosis
  • Compartment Syndromes / epidemiology
  • Compartment Syndromes / etiology
  • Compartment Syndromes / surgery*
  • Decompression, Surgical / statistics & numerical data*
  • Delayed Diagnosis / adverse effects*
  • Delayed Diagnosis / statistics & numerical data
  • Fasciotomy / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thigh / injuries*
  • Thigh / surgery
  • Trauma Centers*
  • Treatment Outcome
  • Wounds, Nonpenetrating / complications*
  • Wounds, Nonpenetrating / epidemiology
  • Wounds, Nonpenetrating / physiopathology
  • Wounds, Nonpenetrating / surgery
  • Young Adult