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Broom A, Schur MD, Arkader A, et al. Compartment syndrome in infants and toddlers. J Child Orthop. 2016;10(5):453-60doi: 10.1007/s11832-016-0766-0.
Broom, A., Schur, M. D., Arkader, A., Flynn, J., Gornitzky, A., & Choi, P. D. (2016). Compartment syndrome in infants and toddlers. Journal of children's orthopaedics, 10(5), 453-60. https://doi.org/10.1007/s11832-016-0766-0
Broom, Alexander, et al. "Compartment syndrome in infants and toddlers." Journal of children's orthopaedics vol. 10,5 (2016): 453-60. doi: https://doi.org/10.1007/s11832-016-0766-0
Broom A, Schur MD, Arkader A, Flynn J, Gornitzky A, Choi PD. Compartment syndrome in infants and toddlers. J Child Orthop. 2016 Oct;10(5):453-60. doi: 10.1007/s11832-016-0766-0. Epub 2016 Aug 18. PMID: 27538943; PMCID: PMC5033785.
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J Child Orthop. 2016 Oct;10(5):453-60. doi: 10.1007/s11832-016-0766-0. Epub 2016 Aug 18.

Compartment syndrome in infants and toddlers.

Journal of children's orthopaedics

Alexander Broom, Mathew D Schur, Alexandre Arkader, John Flynn, Alex Gornitzky, Paul D Choi

Affiliations

  1. Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #69, Los Angeles, CA, 90027, USA.
  2. Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, USA.
  3. Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #69, Los Angeles, CA, 90027, USA. [email protected].

PMID: 27538943 PMCID: PMC5033785 DOI: 10.1007/s11832-016-0766-0

Abstract

PURPOSE: To study the cause, diagnosis, treatment and outcome of acute compartment syndrome in infants and toddlers aged <3 years.

METHODS: Fifteen patients aged <3 years with acute compartment syndrome were identified from two large pediatric trauma centers over a fifteen-year period. All children underwent fasciotomy. The mechanism of injury, time of injury, time to diagnosis, compartment pressures, time to fasciotomy, and outcome at the time of the latest follow-up were recorded.

RESULTS: Nine (60 %) of fifteen patients developed compartment syndrome secondary to trauma, four (4/15, 27 %) due to infection, and two (2/15, 13 %) due to intravenous infiltration. The average time from injury or hospital admission to fasciotomy was 31.8 h (range 2.9-136.3 h). In general, the functional outcome was excellent at the latest follow-up with thirteen (13/15, 87 %) patients having an excellent outcome. No cases of Volkmann's ischemia were noted at the time of fasciotomy, even when performed as late as 5 days after injury.

CONCLUSIONS: Compared to the general pediatric population, the diagnosis of compartment syndrome in infants and toddlers may be further delayed, i.e., >24 h after injury. Despite delays in diagnosis and time to treatment, the present study shows that outcomes in infants and toddlers remain favorable even when fasciotomy is performed 48-72 h after injury.

LEVEL OF EVIDENCE: Case series, level IV.

Keywords: Compartment syndrome; Fasciotomy; IV infiltration; Infection; Pediatric

Conflict of interest statement

Compliance with ethical standards Funding This study was not funded. Conflict of interest AB declares he no conflict of interest. MDS declares he has no conflict of interest. AA is an unpaid consultan

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