Found Down Extremity Compartment Syndrome Secondary to Substance Use

Background:. With the worsening opioid epidemic in America, more patients are developing found down extremity compartment syndrome (FDECS). The purpose of this study was to describe this patient population, including their presenting symptoms, laboratory test results, and clinical outcomes. Methods:...

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Autores principales:	Richard D.J. Smith, MD, DPhil, Sharri J. Mortensen, MD, Dafang Zhang, MD, Malcolm R. Smith, MD, Michael J. Weaver, MD, Arvind G. von Keudell, MD
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/753c5c5c325b4cf4a30b29756efba725
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spelling	oai:doaj.org-article:753c5c5c325b4cf4a30b29756efba7252021-11-25T07:59:02ZFound Down Extremity Compartment Syndrome Secondary to Substance Use2472-724510.2106/JBJS.OA.21.00038https://doaj.org/article/753c5c5c325b4cf4a30b29756efba7252021-12-01T00:00:00Zhttp://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.21.00038https://doaj.org/toc/2472-7245Background:. With the worsening opioid epidemic in America, more patients are developing found down extremity compartment syndrome (FDECS). The purpose of this study was to describe this patient population, including their presenting symptoms, laboratory test results, and clinical outcomes. Methods:. We performed a 2-center retrospective review of adult patients who developed FDECS secondary to substance use from January 2006 to December 2019. Patients were managed operatively or nonoperatively at the surgeon’s discretion. Data on patient demographic characteristics, laboratory values, hospital course, and clinical outcomes were collected from electronic medical records. Results:. In this study, 91 patients were included: 85 patients were managed operatively, and 6 patients were managed nonoperatively. Most patients were male, and the mean patient age (and standard deviation) was 37 ± 11 years. Opioids were the most common substance used. Patients managed operatively underwent a mean of 4 ± 3 surgical procedures, 44% received a skin graft, 25% developed a wound infection, and 11% underwent limb amputation. Patients managed nonoperatively did not undergo a subsequent fasciotomy or amputation. At a mean follow-up of 2.3 years, persistent weakness (66%), pain (78%), persistent sensory deficits (53%), and contractures (18%) were common. Conclusions:. Patients who develop FDECS secondary to substance use have high surgical complication rates and poor clinical outcomes. We found high rates of wound infection, revision surgical procedures, and amputation, often leaving young adults with lifelong disability. Level of Evidence:. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.Richard D.J. Smith, MD, DPhilSharri J. Mortensen, MDDafang Zhang, MDMalcolm R. Smith, MDMichael J. Weaver, MDArvind G. von Keudell, MDWolters KluwerarticleOrthopedic surgeryRD701-811ENJBJS Open Access, Vol 6, Iss 4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 Richard D.J. Smith, MD, DPhil Sharri J. Mortensen, MD Dafang Zhang, MD Malcolm R. Smith, MD Michael J. Weaver, MD Arvind G. von Keudell, MD Found Down Extremity Compartment Syndrome Secondary to Substance Use
description	Background:. With the worsening opioid epidemic in America, more patients are developing found down extremity compartment syndrome (FDECS). The purpose of this study was to describe this patient population, including their presenting symptoms, laboratory test results, and clinical outcomes. Methods:. We performed a 2-center retrospective review of adult patients who developed FDECS secondary to substance use from January 2006 to December 2019. Patients were managed operatively or nonoperatively at the surgeon’s discretion. Data on patient demographic characteristics, laboratory values, hospital course, and clinical outcomes were collected from electronic medical records. Results:. In this study, 91 patients were included: 85 patients were managed operatively, and 6 patients were managed nonoperatively. Most patients were male, and the mean patient age (and standard deviation) was 37 ± 11 years. Opioids were the most common substance used. Patients managed operatively underwent a mean of 4 ± 3 surgical procedures, 44% received a skin graft, 25% developed a wound infection, and 11% underwent limb amputation. Patients managed nonoperatively did not undergo a subsequent fasciotomy or amputation. At a mean follow-up of 2.3 years, persistent weakness (66%), pain (78%), persistent sensory deficits (53%), and contractures (18%) were common. Conclusions:. Patients who develop FDECS secondary to substance use have high surgical complication rates and poor clinical outcomes. We found high rates of wound infection, revision surgical procedures, and amputation, often leaving young adults with lifelong disability. Level of Evidence:. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
format	article
author	Richard D.J. Smith, MD, DPhil Sharri J. Mortensen, MD Dafang Zhang, MD Malcolm R. Smith, MD Michael J. Weaver, MD Arvind G. von Keudell, MD
author_facet	Richard D.J. Smith, MD, DPhil Sharri J. Mortensen, MD Dafang Zhang, MD Malcolm R. Smith, MD Michael J. Weaver, MD Arvind G. von Keudell, MD
author_sort	Richard D.J. Smith, MD, DPhil
title	Found Down Extremity Compartment Syndrome Secondary to Substance Use
title_short	Found Down Extremity Compartment Syndrome Secondary to Substance Use
title_full	Found Down Extremity Compartment Syndrome Secondary to Substance Use
title_fullStr	Found Down Extremity Compartment Syndrome Secondary to Substance Use
title_full_unstemmed	Found Down Extremity Compartment Syndrome Secondary to Substance Use
title_sort	found down extremity compartment syndrome secondary to substance use
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/753c5c5c325b4cf4a30b29756efba725
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Found Down Extremity Compartment Syndrome Secondary to Substance Use

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