Pediatric Upper Extremity Compartment Syndrome: An Analysis of Inpatient Outcomes

Pediatric acute compartment syndrome (PACS) results from increased pressure within a fibro-osseous space, reducing local limb perfusion. It can be traumatic or non-traumatic, often due to fractures, burns, or iatrogenic compression. PACS is challenging to diagnose in children due to insidious onset. While lower extremity PACS is well studied, upper extremity PACS remains underexplored. This study analyzes characteristics and inpatient outcomes of pediatric upper extremity PACS. The National Inpatient Sample (2015 - 2019) was queried for patients under 18 diagnosed with ACS. ICD-10 codes identified fractures, and logistic regression assessed associated factors. Among 1,040 patients, radius (33.2%) and ulna (28.8%) fractures were most common. Transfers (odds ratio [OR] = 3.862), delayed fasciotomy (OR = 5.998), and high injury severity score (OR = 1.132) increased complication risk. Black and Hispanic patients had longer hospital stays. Radius and ulna fractures were most associated with upper extremity PACS. Transfer from another hospital and delayed fasciotomy were independently associated with increased inpatient complications. (Journal of Surgical Orthopaedic Advances 35(3):154-157, 2026).