Compartment Syndrome in Tibial Plateau Fractures: Do Previously Established Predictors Have External Validity?
J Orthop Trauma
; 34(5): 238-243, 2020 May.
Article
in En
| MEDLINE
| ID: mdl-31738237
ABSTRACT
OBJECTIVE:
To test previously established radiographic predictors of compartment syndrome in tibial plateau fractures and determine whether novel measurements may further improve a surgeon's ability to identity patients at high risk for developing this outcome.DESIGN:
Retrospective review.SETTING:
Academic Level I trauma center. PATIENTS Five hundred thirteen patients with tibial plateau fractures treated operatively over a 10-year period (OTA/AO 41B1-3 & 41C1-3; Schatzker I-VI). INTERVENTION Previously established plain film radiographic measurements and novel computed tomography soft tissue measurements. MAIN OUTCOMEMEASURE:
Acute compartment syndrome (ACS).RESULTS:
Schatzker VI fractures (odds ratio 5.72, confidence interval 2.55-12.83, P < 0.001), high-energy mechanism (3.10, 1.26-7.58, P = 0.0096), fibular fracture (8.14, 3.33-19.96, P < 0.0001), fracture length (9.70, 2.45-37.69, P = 0.0014), and plateau-shaft combined injury (2.97, 1.15-7.70, P = 0.019) were all associated with the development of compartment syndrome. The depth of the posterior compartment was also predictive of CS (1.06, 1.02-1.09, P = 0.0025). Patients with 3 and 4 predictive markers demonstrated a 20% and 27% chance of developing ACS respectively.CONCLUSIONS:
This study confirms that several factors are associated with the development of ACS. The presence of each independent predictor had a cumulative effect such that when more than one variable is present, the chance of ACS increases. This information may be used to alert providers regarding injuries that require vigilant evaluation. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tibial Fractures
/
Compartment Syndromes
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
J Orthop Trauma
Journal subject:
ORTOPEDIA
/
TRAUMATOLOGIA
Year:
2020
Document type:
Article