• Ahmed M Thabet, Joshua E Simson, Chris Gerzina, Sherif Dabash, Adam Adler, and Amr A Abdelgawad.
• Department of Orthopaedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, 4801 Alberta Ave, El Paso, TX, 79905, USA.
• Eur J Orthop Surg Tr. 2018 Jan 1; 28 (1): 85-93.

BackgroundAcute compartment syndrome (ACS) is often associated with tibial plateau fractures and is a limb-threatening injury. Staged management through fasciotomy with delayed definitive fixation can prevent muscle necrosis and increase limb salvage rates. This procedure opens a large area for potential contamination and infection in the lower extremity. Recent studies have shown an increased risk of infection following fasciotomy and staged management for tibial plateau fractures. This study reports the rate of infection, delayed union, and nonunion in patients with this injury pattern.MethodsThis study was a retrospective chart review, which received institutional review board approval. It surveyed patient radiographs, clinical notes, and operating room reports from a level I trauma center between 2010 through 2016.ResultsThe results demonstrated that 23 out of 221 consecutive patients with ACS of the lower extremity presented with tibial plateau fracture over a 65-month period. Of these 23 patients, four were lost to follow-up or died. Nineteen patient charts were surveyed, 63% were male (12/19) and 37% were female (7/19). One patient developed deep infection (5.3%). Three patients experienced delayed union (15.8%), and their fractures eventually achieved union without intervention. The mean time to union was 14 weeks. Schatzker type V/VI fractures were the most prevalent type of fractures seen among patients.ConclusionThe infection rate found is lower than in other recently published studies. The incidence of delayed union or nonunion of the fracture was also lower than in other publications in the literature. Early decompression through double- or single-incision fasciotomy does not increase the risk of infection or nonunion of the fracture. The delayed union rates found in this study are lower than those in previous studies.Level Of EvidenceLevel IV prognostic.

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