McQueen Margaret M, Duckworth Andrew D, Aitken Stuart A, Sharma Rowena A, Court-Brown Charles M
*Department of Orthopaedic Trauma, Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom; and †Obstetrics and Gynaecology, North West London Hospitals, London, United Kingdom.
J Orthop Trauma. 2015 Oct;29(10):451-5. doi: 10.1097/BOT.0000000000000347.
The aim of our study was to identify the risk factors associated with the development of acute compartment syndrome (ACS) after a fracture of the tibia.
Retrospective cohort study.
Orthopaedic trauma unit, university teaching hospital.
From our trauma database, we identified all patients who sustained an acute tibial diaphyseal fracture over a 13-year period. A retrospective analysis of 1407 patients was performed to record and analyze the OTA fracture classification, open fracture grade according to Gustilo, soft tissue injury classification according to Tscherne, treatment, development of ACS, and other patient demographics including smoking, occupation, and socioeconomic deprivation.
A diagnosis of ACS was made using clinical signs, compartment pressure monitoring, or a combination of the 2.
One thousand three hundred eighty-eight patients were included with a mean age of 39 (12-98) years, and 957 (69%) were male. One hundred sixty patients (11.5%) were diagnosed with ACS. On initial analysis, age, male gender, blue-collar occupation, sporting injury, fracture classification, and treatment with intramedullary nails were predictive of ACS (all P < 0.05). Age was the strongest predictor of developing ACS (P < 0.001), with the highest prevalence between 12-19 years and 20-29 years. Occupation (P = 0.01) and implant type (P = 0.004) were the only factors that remained significant after adjusting for age. On further subanalysis, implant type was not predictive when stratified by Tscherne class (P = 0.11).
We have documented the risk factors for the development of ACS after an acute tibial diaphyseal fracture, with youth the strongest predictor.
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
我们研究的目的是确定胫骨骨折后发生急性骨筋膜室综合征（ACS）的相关危险因素。
回顾性队列研究。
大学教学医院的骨科创伤科。
从我们的创伤数据库中，我们确定了在13年期间发生急性胫骨干骨折的所有患者。对1407例患者进行回顾性分析，记录并分析OTA骨折分类、根据Gustilo分类的开放性骨折分级、根据Tscherne分类的软组织损伤分级、治疗方法、ACS的发生情况以及其他患者人口统计学特征，包括吸烟、职业和社会经济贫困状况。
使用临床体征、骨筋膜室压力监测或两者结合来诊断ACS。
纳入1388例患者，平均年龄39岁（12 - 98岁），其中957例（69%）为男性。160例（11.5%）被诊断为ACS。初步分析显示，年龄、男性、蓝领职业、运动损伤、骨折分类和髓内钉治疗是ACS的预测因素（所有P < 0.05）。年龄是发生ACS的最强预测因素（P < 0.001），在12 - 19岁和20 - 29岁之间患病率最高。在调整年龄后，职业（P = 0.01）和植入物类型（P = 0.004）是仅有的仍具有显著意义的因素。进一步的亚组分析显示，按Tscherne分级分层时，植入物类型无预测性（P = 0.11）。
我们记录了急性胫骨干骨折后发生ACS的危险因素，其中年轻是最强的预测因素。
预后水平II。有关证据水平的完整描述，请参阅作者指南。
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