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Found Down Extremity Compartment Syndrome Secondary to Substance Use: An Observational Multicenter Study
Richard D J Smith1,2, Sharri J Mortensen3,4, Dafang Zhang2,5
1Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Found down extremity compartment syndrome (FDECS) linked to substance use leads to high complication rates and poor outcomes. Many young adults face lifelong disability from this opioid epidemic complication.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Public Health
Background:
- The opioid epidemic has increased cases of found down extremity compartment syndrome (FDECS).
- Understanding the characteristics and outcomes of FDECS patients is crucial for improving care.
Purpose of the Study:
- To describe the patient population with FDECS secondary to substance use.
- To analyze presenting symptoms, laboratory results, and clinical outcomes.
Main Methods:
- Retrospective review of 91 adult patients with FDECS due to substance use (2006-2019).
- Data collected on demographics, labs, hospital course, and outcomes from electronic medical records.
- Patients managed operatively (85) or nonoperatively (6) at surgeon's discretion.
Main Results:
- Operatively managed patients had a mean of 4 procedures, 44% skin grafts, 25% wound infections, and 11% amputations.
- Nonoperatively managed patients avoided fasciotomy or amputation.
- At 2.3 years follow-up, common sequelae included persistent weakness (66%), pain (78%), and sensory deficits (53%).
Conclusions:
- FDECS secondary to substance use is associated with high surgical complication rates.
- Poor clinical outcomes, including infection, revision surgery, and amputation, are frequent.
- This condition often results in lifelong disability for young adults.
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