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Lower extremity compartment syndrome in infants associated with child abuse: a report of two cases
James F Mooney1, Kathryn E Cramer
1Department of Orthopaedic Surgery, Children's Hospital of Michigan, Detroit, MI 48201, USA. jfm3md@aol.com
Insights
Child abuse can cause compartment syndrome in children, a serious condition often missed. Early recognition and treatment by orthopedic surgeons are crucial for preventing permanent damage.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Child Abuse Forensics
Background:
- Compartment syndrome is a surgical emergency characterized by increased pressure within a fascial compartment, leading to compromised blood flow and tissue damage.
- While commonly associated with fractures and crush injuries, its link to non-accidental trauma in children is underreported.
Observation:
- This report details two pediatric cases of compartment syndrome.
- Both cases resulted from lower extremity fractures sustained due to child abuse.
- The clinical presentation, diagnostic challenges, and management strategies were reviewed.
Findings:
- Compartment syndrome is a previously undocumented complication of pediatric physical abuse.
- Timely diagnosis and surgical intervention, such as fasciotomy, are critical for limb salvage.
Implications:
- Pediatric orthopedic surgeons and healthcare providers must maintain a high index of suspicion for child abuse in cases of unexplained fractures and compartment syndrome.
- Awareness and prompt management are essential to mitigate the severe consequences of this condition in abused children.
Abstract:
Compartment syndrome associated with child abuse is unreported in the literature. We describe two cases secondary to lower extremity fractures resulting from child abuse. The diagnosis and management of compartment syndrome are reviewed. Orthopaedic surgeons involved in the care of pediatric patients must be aware of this potentially devastating complication, and must be prepared for timely management.
