The Effect of Fasciotomy Timing on Limb Vitality and Functionality in Kahramanmaras/Turkey Earthquake.

Abstract

The earthquakes in Kahramanmaras, Turkey, on February 6, 2023, caused many crush injuries complicated by acute compartment syndrome (ACS). This study assessed how fasciotomy timing (rubble-to-fasciotomy time, RFT) affects survival, limb viability, and functional outcomes.We retrospectively analyzed 145 patients (mean age: 29.2 ± 17.5 years) with crush injuries and ACS who underwent fasciotomy. RFT was grouped as 0-24, 25-48, 49-72, 73-96, and >97 hours. Outcomes were classified as full minor deficits, major deficits, amputation and death. Patients with full recovery or minor deficits were considered to have "good outcome," while those with major deficits or amputation were labeled "poor outcome."Full recovery was observed in 35 patients (24.1%), whereas 110 patients (75.9%) experienced complications. The mean RFT was significantly shorter in the good outcome group (25.1 ± 10.9 hours) compared with the poor outcome group (47.1 ± 23.4 hours, p < 0.05). No patients achieved full recovery when fasciotomy was performed after 48 hours. hyperbaric oxygen therapy(HBOT) use was associated with higher rates of good outcomes (p = 0.006), whereas dialysis requirement was associated with poorer outcomes (p = 0.009). Logistic regression analysis demonstrated that HBOT and dialysis remained statistically significant variables associated with functional outcomes (HBOT: p = 0.012; dialysis: p = 0.010). Fasciotomy within 24 hours is essential for functional recovery in ACS. Delays beyond 24 hours resulted in worsening outcomes, with no full recovery after 48 hours. Early surgical intervention in disaster settings is crucial to preserve limb function and viability.