Trauma Induced Acute Compartment Syndrome of the Extremities: Predictors, Interventions, and Patient Outcomes A Critically Appraised Topic
Location
Turner Gymnasium
Access Type
Campus Access Only
Event Website
https://sites.google.com/lynchburg.edu/traumainducedacsofextremities/home
Entry Number
13
Start Date
4-5-2023 12:00 PM
End Date
4-5-2023 1:30 PM
College
College of Health Sciences
Department
Athletic Training
Keywords
acute compartment syndrome, extremity compartment syndrome, compartment syndrome in athletes, lower extremity compartment syndrome
Abstract
Clinical Scenario: Acute compartment syndrome (ACS) is a sudden increase in osteofascial pressure as a result of a traumatic injury. An acute case is an emergency situation that requires surgical intervention. Trauma induced ACS of the extremities follow an injury to the musculoskeletal system and can vary from crushing injuries to avulsion fractures. However, not all ACS cases stem from fracture and the time frame from initial injury to diagnosis and treatment can vary from 4 hours to over 48 hours. Diagnosis and treatment time frames did not have a significant impact on patient outcomes.
Clinical Question: What trauma induced injuries pose the most risk for acute compartment syndrome in the extremities?
Summary of Key Findings: A thorough review yielded 4 studies that were relevant to the clinical question. Acute compartment syndrome (ACS) after trauma in the lower extremity is usually a result of crushing injuries and avulsion fractures especially at the tibial plateau. In the upper extremity they are a result of distal radius fractures, diaphyseal fractures of the radius and ulna, and perilunate dislocations. However, there have been outliers in either extremity that only involved soft tissue impact that did not present out of the ordinary when they occurred.
Clinical Bottom Line: There is moderate evidence that trauma induced compartment syndrome has a higher incidence post fracture and crushing injuries. It is most common in the lower extremity with the highest incidence in the lower leg due to the size and number of muscles in the compartment. While trauma induced compartment syndrome in the forearm has occurred it is still considered rare. Soft tissue injuries and incidence of ACS in the thigh occur but with far less frequency. Predictors for such injuries also vary greatly.
Strength of Recommendation: Moderate evidence exists to support that fractures and crushing injuries pose the highest risk for ACS in the extremities with the highest occurrences happening in the lower portion of the lower extremity.
Faculty Mentor(s)
Dr. Debbie Bradney
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Trauma Induced Acute Compartment Syndrome of the Extremities: Predictors, Interventions, and Patient Outcomes A Critically Appraised Topic
Turner Gymnasium
Clinical Scenario: Acute compartment syndrome (ACS) is a sudden increase in osteofascial pressure as a result of a traumatic injury. An acute case is an emergency situation that requires surgical intervention. Trauma induced ACS of the extremities follow an injury to the musculoskeletal system and can vary from crushing injuries to avulsion fractures. However, not all ACS cases stem from fracture and the time frame from initial injury to diagnosis and treatment can vary from 4 hours to over 48 hours. Diagnosis and treatment time frames did not have a significant impact on patient outcomes.
Clinical Question: What trauma induced injuries pose the most risk for acute compartment syndrome in the extremities?
Summary of Key Findings: A thorough review yielded 4 studies that were relevant to the clinical question. Acute compartment syndrome (ACS) after trauma in the lower extremity is usually a result of crushing injuries and avulsion fractures especially at the tibial plateau. In the upper extremity they are a result of distal radius fractures, diaphyseal fractures of the radius and ulna, and perilunate dislocations. However, there have been outliers in either extremity that only involved soft tissue impact that did not present out of the ordinary when they occurred.
Clinical Bottom Line: There is moderate evidence that trauma induced compartment syndrome has a higher incidence post fracture and crushing injuries. It is most common in the lower extremity with the highest incidence in the lower leg due to the size and number of muscles in the compartment. While trauma induced compartment syndrome in the forearm has occurred it is still considered rare. Soft tissue injuries and incidence of ACS in the thigh occur but with far less frequency. Predictors for such injuries also vary greatly.
Strength of Recommendation: Moderate evidence exists to support that fractures and crushing injuries pose the highest risk for ACS in the extremities with the highest occurrences happening in the lower portion of the lower extremity.
https://digitalshowcase.lynchburg.edu/studentshowcase/2023/posters/12