Abstract：
OBJECTIVE: Currently no guidance exists within the literature regarding diagnostic criteria or the long-term outcomes for paediatric patients with acute compartment syndrome (ACS). We conducted a retrospective cohort study reviewing all cases of paediatric ACS managed at a single tertiary referral centre with the aim of characterising the factors responsible for the eventual outcomes.
METHODS: The patient cohort was identified retrospectively by interrogating the hospital coding system for all paediatric patients between January 2014 and November 2022. The electronic emergency department, inpatient and operative notes as well as clinic letters for each patient were reviewed and data collected regarding presentation, associated injuries, management and subsequent complications plus length of follow-up. The data was analysed to determine if differences in presentation or management affected long term outcome.
RESULTS: The final cohort consisted of 34 patients with a mean age of ten years at the time of presentation. The mean time from presentation to fasciotomy was 27.6 h (range 3.0 - 66.6). There was an overall complication rate of 37.5% with a mean follow-up period of 21 months. Patients who had direct closure of their fasciotomy wounds had a significantly lower complications rate and fewer operations compared to those who healed via other wound coverage methods or secondary intention (p < 0.05).
CONCLUSIONS: Significantly higher complication rates were observed in patients who were unable to have direct wound closure following emergency fasciotomy. This information may be utilised to rationalise long term treatment plans and in counselling of patients and parents.
METHODS: The patient cohort was identified retrospectively by interrogating the hospital coding system for all paediatric patients between January 2014 and November 2022. The electronic emergency department, inpatient and operative notes as well as clinic letters for each patient were reviewed and data collected regarding presentation, associated injuries, management and subsequent complications plus length of follow-up. The data was analysed to determine if differences in presentation or management affected long term outcome.
RESULTS: The final cohort consisted of 34 patients with a mean age of ten years at the time of presentation. The mean time from presentation to fasciotomy was 27.6 h (range 3.0 - 66.6). There was an overall complication rate of 37.5% with a mean follow-up period of 21 months. Patients who had direct closure of their fasciotomy wounds had a significantly lower complications rate and fewer operations compared to those who healed via other wound coverage methods or secondary intention (p < 0.05).
CONCLUSIONS: Significantly higher complication rates were observed in patients who were unable to have direct wound closure following emergency fasciotomy. This information may be utilised to rationalise long term treatment plans and in counselling of patients and parents.
摘要：
目的：目前文献中没有关于急性骨筋膜室综合征（ACS）儿科患者的诊断标准或长期结局的指导。我们进行了一项回顾性队列研究，审查了在单个三级转诊中心管理的所有儿科ACS病例，目的是表征最终结局的原因。
方法：通过询问2014年1月至2022年11月期间所有儿科患者的医院编码系统，对患者队列进行回顾性鉴定。电子急诊室，审查了每位患者的住院和手术记录以及临床信函，并收集了有关报告的数据，相关伤害,治疗和随后的并发症以及随访时间。对数据进行了分析，以确定表达或管理方面的差异是否会影响长期结果。
结果：最后一个队列由34名患者组成，在就诊时平均年龄为10岁。从出现到筋膜切开术的平均时间为27.6h（范围3.0-66.6）。总体并发症发生率为37.5％，平均随访时间为21个月。与通过其他伤口覆盖方法或次要意图治愈的患者相比，直接闭合筋膜切开术伤口的患者的并发症发生率明显较低，手术次数较少（p<0.05）。
结论：在急诊筋膜切开术后不能直接闭合伤口的患者中观察到更高的并发症发生率。此信息可用于合理化长期治疗计划以及对患者和父母的咨询。
方法：通过询问2014年1月至2022年11月期间所有儿科患者的医院编码系统，对患者队列进行回顾性鉴定。电子急诊室，审查了每位患者的住院和手术记录以及临床信函，并收集了有关报告的数据，相关伤害,治疗和随后的并发症以及随访时间。对数据进行了分析，以确定表达或管理方面的差异是否会影响长期结果。
结果：最后一个队列由34名患者组成，在就诊时平均年龄为10岁。从出现到筋膜切开术的平均时间为27.6h（范围3.0-66.6）。总体并发症发生率为37.5％，平均随访时间为21个月。与通过其他伤口覆盖方法或次要意图治愈的患者相比，直接闭合筋膜切开术伤口的患者的并发症发生率明显较低，手术次数较少（p<0.05）。
结论：在急诊筋膜切开术后不能直接闭合伤口的患者中观察到更高的并发症发生率。此信息可用于合理化长期治疗计划以及对患者和父母的咨询。
