Assessing the Rate and Risk Factors of Compartment Syndrome in Pediatric Tibial Tubercle Fractures.

Background: Acute compartment syndrome (ACS) is a limb-threatening complication of pediatric tibial tubercle fractures. Despite its severity, the incidence of ACS in pediatric cases has been largely unexplored. Purpose: We sought to examine the incidence and risk factors of ACS and associated fasciotomies in pediatric patients with tibial tubercle fractures. Methods: We conducted a retrospective cohort study using data from the Pediatric Health Information System, a comprehensive inpatient and outpatient nationwide database. Inclusion criteria specified patients 18 years of age or younger with tibial tubercle fracture ( Results: Of the 6830 included patients with tibial tubercle fractures, 4% had a code for ACS and/or fasciotomy, 1% had a code for ACS and a procedure code for fasciotomy, and 2.9% had a code for fasciotomy only. Univariate analysis revealed that older and male patients had higher rates of ACS and fasciotomies without any corresponding diagnosis of ACS, compared to their counterparts; White patients had higher rates of ACS than patients of other races. Multivariate analysis showed that age was the only significant predictor of ACS across all groups. Conclusion: This retrospective database study suggests that ACS is a rare complication of pediatric tibial tubercle fractures and that fasciotomies without any evidence of ACS-interpreted as prophylactic fasciotomies-occur at a higher rate than formally diagnosed ACS. Level of Evidence: Level IV: Retrospective Cohort Study.