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Review
. 2023 Oct;18(7):1177-1182.
doi: 10.1177/15589447221084012. Epub 2022 Mar 21.

Surgical Demographics of Acute Hand Compartment Syndrome

Derrick W Williams  1 , George S M Dyer  1   2 , Arvind von Keudell  1   2 , Dafang Zhang  1   2
Affiliations
Review

Surgical Demographics of Acute Hand Compartment Syndrome

Derrick W Williams et al. Hand (N Y). 2023 Oct.

Abstract

Background: We aimed to describe the demographic, injury-related, and treatment-related characteristics of patients who undergo fasciotomies for acute hand compartment syndrome.

Methods: A cohort of 53 adult patients with acute hand compartment syndrome treated with fasciotomy at 2 tertiary care referral centers over a 10-year time period from January 1, 2006, to June 30, 2015, were retrospectively identified. We reviewed the electronic medical record for patient-related variables (eg, age, sex, smoking status, diabetes mellitus), injury-related variables (eg, mechanism of injury, presence of fractures), and treatment-related variables (eg, compartments released, number of operations, use of split-thickness skin grafts, and time from injury to surgery).

Results: The mean age of our cohort was 45 years, and 33 patients (62%) were men. The mechanism of injury varied widely, but the most common causative mechanisms were crush injury (25%), prolonged decubitus (17%), and infection (11%). Associated hand fractures were present in 15 (28%) patients. The surgically released compartments varied; the dorsal interosseous compartments (83%), thenar compartment (75%), and hypothenar compartment (74%) were most frequently released, while the adductor pollicis compartment (43%) and Guyon canal (28%) were least frequently released.

Conclusions: The demographics of acute hand compartment syndrome have evolved in the last 25 years compared with the prior literature, partly as a result of the opioid epidemic leading to a rise in "found down" compartment syndrome. Treating providers should recognize crush injury, prolonged decubitus, and infection as the most common causes of acute hand compartment syndrome.

Keywords: Guyon canal; acute compartment syndrome; carpal tunnel; crush injury; found down; hand; trauma.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study inclusion flow diagram.
Figure 2.
Figure 2.
Histogram depicting the number of operations for patients treated with fasciotomy for acute hand compartment syndrome.
See this image and copyright information in PMC

References

    1. Zhang D, Tarabochia M, Janssen SJ, et al.. Acute compartment syndrome in patients undergoing fasciotomy of the forearm and the leg. Int Orthop. 2019;43(6):1465-1472. - PubMed
    1. Oak NR, Abrams RA. Compartment syndrome of the hand. Orthop Clin North Am. 2016;47(3):609-616. - PubMed
    1. Rubinstein AJ, Ahmed IH, Vosbikian MM. Hand compartment syndrome. Hand Clin. 2018;34(1):41-52. - PubMed
    1. Parzych L, Jo J, Diwan A, et al.. “Found Down” compartment syndrome: experience from the front lines of the opioid epidemic. J Bone Joint Surg Am. 2019;101(17):1569-1574. - PubMed
    1. Zhang D, Janssen SJ, Tarabochia M, et al.. Factors associated with poor outcomes in acute forearm compartment syndrome. Hand (NY). 2021;16:679-685. - PMC - PubMed

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