Compartment syndrome in children and adolescents.

BACKGROUND: The authors performed a computerized search of the National Pediatric Trauma Registry for all patients who had compartment syndrome during a 51-month period.

METHODS: One hundred thirty-three cases were identified. Boys outnumbered girls 4 to 1. The median age was 12 years and the peak incidence was in the 10- to 14-year-old age group.

RESULTS: The most common mechanisms of injury were pedestrians struck by motor vehicles, falls, sports, and occupants in motor vehicle crashes. Eighty-five percent of the cases were the sequelae of fractures. Forearm fractures were the most common cause in the upper extremity, and tibia and/or fibula fractures were most common in the lower extremity.

CONCLUSIONS: Open fractures significantly increased the risk of developing a compartment syndrome for both forearm and leg fractures. Sixty percent of the patients went directly from the emergency room to the operating room, suggesting that the others developed the compartment syndrome after admission, or had delayed diagnosis.