Forearm fasciotomies for acute compartment syndrome: Big data analysis

Purpose

To investigate the incidence, risk factors, demographics, and association in the analysis of acute compartment syndrome of the forearm.

Methods

A retrospective review of the Trauma Quality Programs data from the American College of Surgeons. This includes 120,556 patients who sustained a forearm fracture from 2015 to 2018 (4 calendar years). The main outcome measurements are fasciotomies performed after sustaining a forearm fracture, thus suggesting acute compartment syndrome.

Results

Fasciotomies were performed in 1.6% of all forearm fractures. Open fractures were 5 times more likely to lead to fasciotomies. Being a male was associated with an increased likelihood of fasciotomies of 64%. Complex fractures (OTA type C) exhibited 74% stronger likelihood of fasciotomies compared to simple fractures. Patients with a history of substance abuse disorder (SAD) were 45% more likely to undergo a fasciotomy compared to patient with no SAD. Multiple other factors were addressed while controlling for cofounders.

Conclusion

This big data analysis provided a holistic perspective on the risk factors, demographics, and clinical association of ACS in the forearm. There is a clear need for a gold standard diagnosis for ACS to provide better care for the patients: whether it is continuous pressure monitoring, validated biomarkers, or other biomarkers.

Level of Evidence

III, retrospective database cohort study.