Abstract
BackgroundThe purpose of the present study is to investigate the therapeutic effect of fasciotomy through multiple small skin incisions for the treatment of early osteofascial compartment syndrome in children.MethodsFrom January 2009 to May 2017, 56 pediatric patients with early osteofascial compartment syndrome in their limbs were admitted into our department and treated with multiple small skin incisions for decompression at the early stage. The skin incisions, function, and sensation of the limbs were followed up.ResultsThe osteofascial compartment syndrome was diagnosed at 7.4 ± 2.1 h after injury, and then fasciotomy was performed at 1.4 ± 0.4 h later. The average procedure time of fasciotomy was 12.7 ± 4.8 min. No postoperative incision infections or neurovascular injuries were observed in all the patients. The incisions completely healed in 7–10 days with an average healing time of 8 days without secondary suture. The patients were followed up for an average of 5.1 years. No Volkmann’s contractures in the injured limbs were found. The appearance, electromyography, and nerve conduction velocity of the affected limbs were not significantly different from that of the contralateral limbs. All the patients were free of symptoms and were fully recovered of sensation and function, being an “excellent” outcome at the latest follow-up.ConclusionFasciotomy through multiple small skin incisions, which can be useful to decompress the compartment pressure with fewer complications, is a simple and effective strategy for the treatment of early osteofascial compartment syndrome in children.
Highlights
Osteofascial compartment syndrome (OCS) is one of the serious emergency conditions in pediatric orthopedics that is often accompanied by extremity fractures, vascular injuries, soft tissue crush injuries caused by car accidents or earthquakes, and improper external fixation [1, 2]
The early osteofascial compartment syndrome (OCS) was diagnosed and evaluated by two experienced surgeons according to signs and symptoms of the patients [2,3,4]
Thirty-two cases were injured in car accidents, Table 1 The demographic profiles of the 56 patients with early osteofascial compartment syndrome
Summary
Osteofascial compartment syndrome (OCS) is one of the serious emergency conditions in pediatric orthopedics that is often accompanied by extremity fractures, vascular injuries, soft tissue crush injuries caused by car accidents or earthquakes, and improper external fixation [1, 2]. Twelve percent to 21% of cases require a second operation such as skin grafting or tissue expansion to close the wound [5, 6]. Since these serious complications, the traditional fasciotomy is applied scrupulously in the early OCS, especially in the doubtful cases, missing the best time for treatment, leading to neuromusrosis and subsequent poor outcomes. The purpose of the present study is to investigate the therapeutic effect of fasciotomy through multiple small skin incisions for the treatment of early osteofascial compartment syndrome in children
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