TY - JOUR
T1 - Characteristics and outcomes of patients who undergo fasciotomies for upper arm compartment syndrome
AU - Williams, Derrick W
AU - Dyer, George S M
AU - von Keudell, Arvind
AU - Zhang, Dafang
N1 - © 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
PY - 2023/8
Y1 - 2023/8
N2 - PURPOSE: Describe the demographic, injury-related, treatment-related, and outcome-related characteristics of patients who undergo fasciotomies for acute upper arm compartment syndrome (ACS).METHODS: From January 1, 2006, to June 30, 2015, 438 patients with a diagnosis code of upper extremity (including hand, forearm, arm, and shoulder) compartment syndrome at two tertiary care centers were identified. Of those patients, 423 were excluded for a diagnosis other than upper arm ACS or incomplete documentation. A final cohort of 15 adult patients with acute upper arm compartment syndrome treated with fasciotomy was included. The electronic medical record for patient-related variables, lab data, mechanism of injury, presence of additional injuries, and treatment-related variables were reviewed.RESULTS: The mean age of our cohort was 52 years, and 73% were male. The most common mechanisms of injury were blunt trauma (20%), vascular injury (20%), oncologic resection (13%), and infection related to intravenous drug use (13%). Humerus fractures and biceps tendon ruptures were associated with 13 and 27% of the cases, respectively. More than two-thirds of the patients had elevated international normalized ratios (INR). While 27% of cases underwent fasciotomy within 6 h after injury, seven patients (47%) underwent fasciotomy more than 24 h after injury. Six patients had no major deficits, while 7 patients had long-term deficits.CONCLUSION: Upper arm ACS is a potentially devastating condition that can be seen after blunt trauma, vascular injury, oncologic resection, and intravenous drug use. Clinicians should have high suspicion in cases of elevated INR and biceps tendon rupture.
AB - PURPOSE: Describe the demographic, injury-related, treatment-related, and outcome-related characteristics of patients who undergo fasciotomies for acute upper arm compartment syndrome (ACS).METHODS: From January 1, 2006, to June 30, 2015, 438 patients with a diagnosis code of upper extremity (including hand, forearm, arm, and shoulder) compartment syndrome at two tertiary care centers were identified. Of those patients, 423 were excluded for a diagnosis other than upper arm ACS or incomplete documentation. A final cohort of 15 adult patients with acute upper arm compartment syndrome treated with fasciotomy was included. The electronic medical record for patient-related variables, lab data, mechanism of injury, presence of additional injuries, and treatment-related variables were reviewed.RESULTS: The mean age of our cohort was 52 years, and 73% were male. The most common mechanisms of injury were blunt trauma (20%), vascular injury (20%), oncologic resection (13%), and infection related to intravenous drug use (13%). Humerus fractures and biceps tendon ruptures were associated with 13 and 27% of the cases, respectively. More than two-thirds of the patients had elevated international normalized ratios (INR). While 27% of cases underwent fasciotomy within 6 h after injury, seven patients (47%) underwent fasciotomy more than 24 h after injury. Six patients had no major deficits, while 7 patients had long-term deficits.CONCLUSION: Upper arm ACS is a potentially devastating condition that can be seen after blunt trauma, vascular injury, oncologic resection, and intravenous drug use. Clinicians should have high suspicion in cases of elevated INR and biceps tendon rupture.
KW - Adult
KW - Arm/surgery
KW - Compartment Syndromes/diagnosis
KW - Fasciotomy
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Tendon Injuries/surgery
KW - Upper Extremity/surgery
KW - Vascular System Injuries
KW - Wounds, Nonpenetrating/complications
KW - Trauma
KW - Acute compartment syndrome
KW - Brachium
KW - Upper arm
KW - Arm
UR - http://www.scopus.com/inward/record.url?scp=85141374270&partnerID=8YFLogxK
U2 - 10.1007/s00590-022-03416-7
DO - 10.1007/s00590-022-03416-7
M3 - Journal article
C2 - 36344794
SN - 1633-8065
VL - 33
SP - 2291
EP - 2296
JO - European Journal of Orthopaedic Surgery & Traumatology
JF - European Journal of Orthopaedic Surgery & Traumatology
IS - 6
ER -