PMID- 34646972
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220427
IS  - 2472-7245 (Electronic)
IS  - 2472-7245 (Linking)
VI  - 6
IP  - 4
DP  - 2021 Oct-Dec
TI  - Found Down Extremity Compartment Syndrome Secondary to Substance Use: An 
      Observational Multicenter Study.
LID - 10.2106/JBJS.OA.21.00038 [doi]
LID - e21.00038
AB  - 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.
CI  - Copyright (c) 2021 The Authors. Published by The Journal of Bone and Joint Surgery, 
      Incorporated. All rights reserved.
FAU - Smith, Richard D J
AU  - Smith RDJ
AD  - Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard 
      Medical School, Boston, Massachusetts.
AD  - Harvard Orthopaedic Trauma Initiative, Harvard Medical School, Boston, 
      Massachusetts.
FAU - Mortensen, Sharri J
AU  - Mortensen SJ
AD  - Harvard Medical School, Boston, Massachusetts.
AD  - Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 
      Boston, Massachusetts.
FAU - Zhang, Dafang
AU  - Zhang D
AD  - Harvard Orthopaedic Trauma Initiative, Harvard Medical School, Boston, 
      Massachusetts.
AD  - Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical 
      School, Boston, Massachusetts.
FAU - Smith, Malcolm R
AU  - Smith MR
AD  - Department of Orthopaedic Surgery, UMass Memorial Medical Center, Worcester, 
      Massachusetts.
FAU - Weaver, Michael J
AU  - Weaver MJ
AD  - Harvard Orthopaedic Trauma Initiative, Harvard Medical School, Boston, 
      Massachusetts.
AD  - Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical 
      School, Boston, Massachusetts.
FAU - von Keudell, Arvind G
AU  - von Keudell AG
AD  - Harvard Orthopaedic Trauma Initiative, Harvard Medical School, Boston, 
      Massachusetts.
AD  - Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical 
      School, Boston, Massachusetts.
LA  - eng
PT  - Journal Article
DEP - 20211006
PL  - United States
TA  - JB JS Open Access
JT  - JB & JS open access
JID - 101726219
PMC - PMC8500555
COIS- Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided 
      with the online version of the article (http://links.lww.com/JBJSOA/A321).
EDAT- 2021/10/15 06:00
MHDA- 2021/10/15 06:01
PMCR- 2021/10/06
CRDT- 2021/10/14 06:41
PHST- 2021/10/14 06:41 [entrez]
PHST- 2021/10/15 06:00 [pubmed]
PHST- 2021/10/15 06:01 [medline]
PHST- 2021/10/06 00:00 [pmc-release]
AID - JBJSOA-D-21-00038 [pii]
AID - 10.2106/JBJS.OA.21.00038 [doi]
PST - epublish
SO  - JB JS Open Access. 2021 Oct 6;6(4):e21.00038. doi: 10.2106/JBJS.OA.21.00038. 
      eCollection 2021 Oct-Dec.