Frequency of Compartment Syndrome in Patients Presenting with Fractures of Tibia in A Tertiary Care Facility

Abstract

Objective: To determine the  frequency  of  compartment  syndrome  in  patients  presenting  with  fracture of tibia in a tertiary care facility.

Methods: In our descriptive cross-  sectional  studied  conducted  from  January  2018  to  June  2018  at the Department of Orthopaedics, Jinnah Postgraduate Medical Centre, Karachi,  we  included  136  pa- tients in this study with age range between 18 to 45 years of either gender presenting with closetibial      shaft fracture within 24 hours of  injury.  Brief  history  regarding  the  duration  of  fracture  and  comorbid like HTN was obtained. Patients with diabetes mellitus, chronic  bleeding  and  renal  disorders  and  I.V drug abusers were excluded from the study. Presence of any one or more of the following within 24       hours of injury were labelled as compartment syndrome: severe pain: VAS  score 7 or more, limb pa-  ralysis: unable to move limb, paraesthesia: mild or no sensation on pin prick, pallor, as compared to contralateral limb and pulselessness: absence of pulse on Doppler.

Results: Mean age of the patients was 35.01 ± 9.34 years.More patients (n=72, 52.9%) were found older than 35 years of age while 64 (47.1%) patients with ?35 years of age. There were 99 (72.8%) males         and 37 (27.2%) females. Mean weight, height and BMI of the patients were 60.11  ± 5.12 kg, 1.53 ±      0.06m and 27.23 ± 5.02kg/m2 respectively. Average duration of fracture was 21.85 ± 1.63 hours. Majority (n=114, 83.8%) of the patients presented with >20 hours. Compartment syndrome was found in 9 (6.6%) patients out of 136 cases. A significant association of compartment syndrome was found with age (p-    value 0.025), and BMI (p-value 0.043) of the patients. Out of nine patients with compartment syndrome, eight patients were older than 35 years. In contrast, BMI in eight patients diagnosed with compartment syndrome were less than 30. However, no significant findings were noted in relation to duration of frac-    ture (p-value 0.201), smoking status (p-value 0.097) and HTN (p-value 0.108).

Conclusion: Compartment syndrome is a surgical emergency, which needs timely diagnosis and im- mediate decompression to avoid complications including limb loss.