Etiology of trauma-related acute compartment syndrome of the forearm: a systematic review

Abstract

Objectives Acute compartment syndrome (ACS) can be caused by multiple causes that affect people of different ages. It is considered an orthopedic emergency condition that requires immediate diagnosis and surgical intervention to avoid devastating complications and irreversible damages. This systematic review aimed to present the etiology of trauma-related forearm ACS. Methods A systematic review was performed on four different databases: Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of systematic review register databases via Ovid, with no restriction on dates (last date was June 30, 2021). It included all the studies containing data about the etiology of trauma-related forearm ACS. Results A total of 4893 articles were retrieved: 122 met the inclusion criteria, 39 were excluded, 25 were out of scope and 14 had insufficient details. Hence, this review constituted 83 articles and 684 patients. The etiology of ACS causing forearm ACS was classified into three groups: fracture-related, soft tissue injury-related and vascular injury-related. The fracture-related group was the most common group (65.4%), followed by soft tissue injury (30.7%), then vascular injuries (3.9%). Furthermore, supracondylar humerus fractures were the most common cause of fractures related to forearm ACS. Blunt traumas were the most common cause of soft tissue injuries-related forearm ACS, and brachial artery injuries were the most common cause of vascular-related forearm ACS. Conclusion Frequent assessment of patients with the most prevalent etiologies of forearm ACS is recommended for early detection of forearm ACS and to save limbs.

Etiology of Trauma-Related Acute Compartment Syndrome of the Hand: A Systematic Review

“…Following our review of the literature, only seven patients who developed compartment syndrome following a fracture were found, with no consistency in the mechanism of injury or type of fracture. In contrast, previous reviews found that fractures were the most common cause of foot, leg, and forearm compartment syndrome [ 45 - 48 ].…”

Predictors of Acute Compartment Syndrome in Patients With Forearm Fractures: A Systematic Review

“…All seven articles provided relevant evidence of patients’ history of fractures as the main reason for developing ACS [ 5 , 6 , 8 , 11 ] and identified radius, ulna, and both-bone fractures in the arm as the leading risk factors for patients who developed ACS. Overall, 50% of the articles with fracture-related ACS identified both-bone fractures as the most common cause of ACS [ 5 , 11 ]. Table 3 provides detailed information on the prevalence of ACS in distinct fracture types.…”

“…Open-arm fractures were contended as a potent cause of ACS due to conflicting logic on how the pressure would build up in an open-arm fracture. However, fractures of the tibia and diaphysis and the arm radius were identified as a common cause of ACS [ 5 , 6 , 8 , 11 ]. Vascular injuries and substance abuse disorders were the least common causes of ACS and were reported in only two of the seven studies included in this review [ 6 , 10 ].…”

“…This underscores the notable impact of specific fracture sites on the incidence of forearm ACS. ICPs >30 mmHg were reported in 30% of the studies under review to diagnose ACS among patients presenting with a history or current forearm fractures [ 10 , 11 ].…”

“…Their systematic review reported that fracture-related ACS was the most frequent (65.4%), followed by cases involving soft tissue injury (30.7%), and, subsequently, cases associated with vascular injuries (3.9%) as far as predisposing risk factors for ACS were concerned. Among fractures contributing to forearm ACS, supracondylar humerus fractures stood out as the primary instigator [ 11 ].…”