Etiology of Trauma-Related Acute Compartment Syndrome of the Hand: A Systematic Review.

Abstract

Hand compartment syndrome is a limb-threatening emergency. Although it is a relatively uncommon condition, early diagnosis, and urgent fasciotomy can prevent irreversible ischemia, myonecrosis, nerve dysfunction, and subsequently permanent loss of hand functions. The occurrence of hand compartment syndrome is relatively infrequent, resulting in a limited amount of literature on its causes. As a result, we conducted a systematic review to provide the most comprehensive data regarding the etiology of traumatic hand compartment syndrome. This systematic review was conducted and reported in light of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. We searched among Medline, and EBSCO Database, with no restriction on the dates (last date of the systematic search was done on April 28, 2022). We included all studies containing data regarding traumatic hand compartment syndrome. A total of 29 articles with 129 patients constituted the basis of this review. The etiology of traumatic hand compartment syndrome was classified into three groups: soft tissue injury-related, fracture-related, and vascular injury-related causes. The most common etiology of hand compartment was related to soft tissue injuries which constituted 86.8% of all etiologies, followed by fracture-related (5.4%), then vascular injury-related (1.5%). Further, burns were the most likely injury to lead to hand compartment syndrome which made up 63.4% of soft-tissue injuries, followed by animal bites (8.9%). Hand compartment syndrome can be caused by multiple etiologies that affect people of different ages. Therefore, identifying the most prevalent causes can help in early detection of compartment syndrome by frequent assessment of patients that present with the most prevalent causes like burn among soft tissue injuries and metacarpal bone fracture among fractures.