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Published on: May 31, 2019
Predictors of acute compartment syndrome in patients with tibial fractures: a meta-analysis
Tao Wang1,2, Junfei Guo1,2, Yubin Long1,2
1Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Study Design:
This is the first meta-analysis focusing on the risk factors related to ACS after tibial fractures.
Background:
Acute compartment syndrome (ACS) is a serious complication that affects 2-9% of tibial fracture patients. It is importance of identifying the predictors of ACS in patients with tibial fractures.
Questions/Purposes:
We performed a meta-analysis to identify the risk factors of ACS after tibial fracture.
Methods:
We searched articles in the English databases, such as PubMed, Embase, and the Cochrane Library and the Chinese databases including CNKI and WAN FANG. We collected data related to ACS from included studies and analyzed data by RevMan 5.3 and STATA 12.0.
Results:
The rate of ACS was 2.7% (10,708 of 398,414 patients) from 16 included articles. Our data showed that younger age (p < 0.00001, OR = - 7.93, 95% CI [- 9.34, - 6.25]), male patients (p < 0.00001, OR = 2.17, 95% CI [2.07, 2.28]), patients without a history of hypertension (p < 0.00001, OR = 0.69, 95% CI [0.64, 0.74]), with a history of smoking (p < 0.00001, OR = 1.38, 95% CI [1.30, 1.46]), and patients with fibular fractures (p = 0.001, OR = 2.68, 95% CI [1.47, 4.87]), closed fracture (p = 0.02, OR = 0.86, 95% CI [0.75, 0.98]), high-energy injury (p = 0.003, OR = 0.37, 95% CI [0.19, 0.71]), motorized accident (p = 0.0009, OR = 0.41, 95% CI [0.24, 0.69]), proximal fracture, AO-C-type fracture, comminuted fracture, and Schatzker grade IV-VI fracture were associated with the development of ACS. Additionally, femoral displacement ratio and tibial widening ratio in the ACS groups were significantly higher than in the non-ACS group.
Conclusion:
Many factors were found to be associated with the development of ACS following tibial fractures. We provide references when we met the above characteristics of patients to rapidly identify and highly concern ACS.
