Compartment syndrome a complication of fracture of long bones as seen in Kenyatta National Hospital -a five years descriptive study

Abstract

This was a retrospective descriptive study covering a period of 5 years (1995-1999). Admitted cases of fractures of the long bones were identified using lCD 10 code. We did proportionate sampling from each year based on the number of cases of long bone fracture admissions. The selected files were reviewed and data was extracted by the principle investigator using a structured questionnaire Of 6,175 cases of fractures of the long bones admitted during the study period 737 files were sampled. Four hundred and eight (55.36%) were males and three hundred and twenty nine (44.64%) were females. Ninety (12.2%) were found to have developed compartment syndrome. Among those who developed compartment syndrome 51(57%) were males and 39 (43%) were females (P=0.7)). Among cases managed within 24 hours or less 1.3% developed complications compared to 75% of those managed after 24 hours (P< 0.001). Although there were no fatalities, 10 (11%) patients who developed compartment syndrome ended up with serious morbidity. The frequency of compartment syndrome increased from 5% in 1995 to 17% in 1999 (P=0.002). Compartment syndrome was commonest in the age group 21-30 (17%) and 31-40 (18%) and least common in the age group <10 (6%) and >50 (10%) (P=0.03). Compartment syndrome was commonest,6% after tibia/fibula fractures, 4% after radius/ulna fractures, 3% after humerus fracture and 0.3% after. femur fracture In conclusion we found that compartment syndrome is common and is being increasingly recognized. Tibia/fibula fractures and those in the age group of 21-40 years are at the highest risk of compartment syndrome. Early recognition and treatment is essential to avoid complications.