Association of trauma severity scores with limb amputation and death in acute leg compartment syndrome

Zhang, Dafang; Tarabochia, Matthew; Keudell, Arvind von

doi:10.1007/s00590-020-02818-9

Cited by 6 publications

(10 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,5,11 Nearly 50% of our cohort actively smoked, which is higher than previous reports in the forearm and leg. 5,6,11 Smoking may predispose to acute compartment syndrome due to peripheral vascular disease and baseline relative tissue ischemia. 6 The most common injury mechanisms resulting in acute hand compartment syndrome in our series were crush injury, prolonged decubitus, and infection.…”

Section: Discussionmentioning

confidence: 99%

“…5,6,11 Smoking may predispose to acute compartment syndrome due to peripheral vascular disease and baseline relative tissue ischemia. 6 The most common injury mechanisms resulting in acute hand compartment syndrome in our series were crush injury, prolonged decubitus, and infection. This finding is in contrast with Ouellette and Kelly 8 1996 case series of 10 adult patients with acute hand compartment syndrome, in which 6 patients developed acute hand compartment syndrome from intravenous infiltrations, 2 from crush injury, 1 from a penetrating injury, and 1 from postsurgical swelling.…”

Section: Discussionmentioning

confidence: 99%

“…Delay in treatment is associated with poor outcomes, including neurologic deficits, musculotendinous contractures, or limb amputation. 4-6…”

Section: Introductionmentioning

confidence: 99%

“…Delay in treatment is associated with poor outcomes, including neurologic deficits, musculotendinous contractures, or limb amputation. [4][5][6] There are 10 closed fascial compartments of the hand, comprising 4 dorsal interosseous compartments, 3 volar interosseous compartments, the thenar compartment, the hypothenar compartment, and the adductor pollicis compartment. 3,4 Some authors additionally include the carpal tunnel and Guyon canal as closed fascial compartments of the hand.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Surgical Demographics of Acute Hand Compartment Syndrome

Dyer

Keudell

Zhang

2022

Hand (New York, N,Y.)

Self Cite

View full text Add to dashboard Cite

Background: We aimed to describe the demographic, injury-related, and treatment-related characteristics of patients who undergo fasciotomies for acute hand compartment syndrome. Methods: A cohort of 53 adult patients with acute hand compartment syndrome treated with fasciotomy at 2 tertiary care referral centers over a 10-year time period from January 1, 2006, to June 30, 2015, were retrospectively identified. We reviewed the electronic medical record for patient-related variables (eg, age, sex, smoking status, diabetes mellitus), injury-related variables (eg, mechanism of injury, presence of fractures), and treatment-related variables (eg, compartments released, number of operations, use of split-thickness skin grafts, and time from injury to surgery). Results: The mean age of our cohort was 45 years, and 33 patients (62%) were men. The mechanism of injury varied widely, but the most common causative mechanisms were crush injury (25%), prolonged decubitus (17%), and infection (11%). Associated hand fractures were present in 15 (28%) patients. The surgically released compartments varied; the dorsal interosseous compartments (83%), thenar compartment (75%), and hypothenar compartment (74%) were most frequently released, while the adductor pollicis compartment (43%) and Guyon canal (28%) were least frequently released. Conclusions: The demographics of acute hand compartment syndrome have evolved in the last 25 years compared with the prior literature, partly as a result of the opioid epidemic leading to a rise in “found down” compartment syndrome. Treating providers should recognize crush injury, prolonged decubitus, and infection as the most common causes of acute hand compartment syndrome.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Delay in treatment is associated with poor outcomes, including neurologic deficits, musculotendinous contractures, or limb amputation. 4-6…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Demographics of Acute Hand Compartment Syndrome

Dyer

Keudell

Zhang

2022

Hand (New York, N,Y.)

Self Cite

View full text Add to dashboard Cite

show abstract

“…Zhang et al discovered that diabetes mellitus, lack of intercompartmental pressure measurements, long partial thromboplastin time, and low albumin levels were risk factors associated with amputation in 546 ACS patients [ 5 ]. Other related studies have found that elevated creatine kinase levels, smoking, open fractures, trauma severity, and high-energy injuries are associated with amputation in patients with ACS [ 6 , 7 ]. The incidence of serious complications of ACS is high, with a mortality rate of 2–15% and an amputation rate of 10–21% according to published studies [ 5 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

A practical nomogram for predicting amputation rates in acute compartment syndrome patients based on clinical factors and biochemical blood markers

Wei

Jiang

Huang

et al. 2023

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Amputation is a serious complication of acute compartment syndrome (ACS), and predicting the risk factors associated with amputation remains a challenge for surgeons. The aim of this study was to analyze the risk factors for amputation in patients with ACS and develop a nomogram to predict amputation risk more accurately. Methods The study population consisted of 143 patients (32 in the amputation group and 111 in the limb preservation group) diagnosed with ACS. LASSO and multivariate logistic regression were used to screen predictors and create a nomogram. The model’s accuracy was assessed by receiver operating characteristic (ROC) curves, C-index, calibration curves, and decision curve analysis (DCA). Results The predictors included cause of injury, vascular damage, shock, and fibrinogen in the nomogram. The C-index of the model was 0.872 (95% confidence interval: 0.854–0.962), and the C-index calculated by internal validation was 0.838. The nomogram’s area under the curve (AUC) was 0.849, and the calibration curve demonstrated a high degree of agreement between the nomogram’s predictions and actual observations. Additionally, the DCA indicated good clinical utility for the nomogram. Conclusion The risk of amputation in ACS patients is associated with the cause of injury, vascular damage, shock, and fibrinogen. Our nomogram integrating clinical factors and biochemical blood markers enables doctors to more conveniently predict the risk of amputation in patients with ACS.

show abstract