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Acute Traumatic Compartment Syndrome in Pediatric Foot: A Systematic Review and Case Report
Kelly Wallin1, Hienvu Nguyen2, Lindsay Russell3
1Site Director, Foot and Ankle Surgery Residency Program, Postgraduate Year 3, Department of Orthopaedic Surgery, Kaiser Permanente South Sacramento Medical Center, South Sacramento, CA.
Insights
Acute compartment syndrome (ACS) in children is rare but serious. Early recognition and fasciotomy are crucial for pediatric lower extremity trauma to prevent permanent complications.
Area of Science:
- Orthopedics
- Pediatric Surgery
- Trauma Surgery
Background:
- Acute compartment syndrome (ACS) of the lower extremity is a severe complication following trauma.
- While well-documented in adults, ACS in the pediatric population is infrequently reported.
- Pediatric patients face unique challenges, including inconclusive radiographic findings and communication barriers, increasing the risk of delayed diagnosis.
Abstract:
Acute compartment syndrome of the lower leg and foot is a not widely reported, but serious, potential complication that can develop after fractures, crush injuries, or high-velocity trauma of the lower extremity. Early recognition and treatment are critical in preventing morbidity and permanent complications. Although compartment syndrome of the lower leg and foot has been well-studied and documented in adults, its occurrence in the pediatric population is rare. We performed a systematic review of the published data and present the case of the youngest patient with isolated ACS of the foot. A high index of suspicion is warranted in pediatric patients with a traumatic injury to the lower extremity for compartment syndrome. Inconclusive radiographic findings owing to skeletal immaturity and the inability to verbalize symptoms place young children at high risk of undiagnosed compartment syndrome. Clinicians should have a very low threshold for fasciotomy to prevent long-term sequelae associated with undiagnosed compartment syndrome.
