Frequency of Compartment Syndrome in Patients Presenting with Fractures of Tibia in A Tertiary Care Facility
Keywords:Compartment syndromes, tibia, tibial fractures, patients.
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.