Abstract
The authors analyzed 11 upper extremity fasciotomies performed for specific clinical indications following trauma and evaluated the reliability of the clinical diagnosis and causes of postsurgical reduced functional recovery. Tissue-pressure measurements were not used in this study. Types of injury in 11 study patients included: four (36%) gunshot, three (27%) blunt, three (27%) intravascular drug injections, and one (9%) shotgun. Average time from injury to fasciotomy was 9.25 (range: 2 to 18) hours. After follow-up evaluation at 6 weeks to 3 months, four (36%) patients had full functional recovery of the limb; 7 (64%) had diminished function. Two patients required amputation: one after a shotgun injury complicated by sepsis and another in a drug-abuse patient with pressure necrosis secondary to an extended period of prehospital unconsciousness. Diagnosis of upper extremity compartment syndrome was reliably made by using specific and accepted clinical criteria. Despite early fasciotomy, significant morbidity resulted.
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