The Research About Acute Compartment Syndrome

Study Overview
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Brief Summary
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Acute compartment syndrome (ACS) is defined as a clinical entity originated from trauma or other conditions, and remains challenging to diagnose and treat effectively. Threre is the controversy in diagnosing, treating ACS. It was found that there was no criterion about the ACS, and result unnecessary osteotomy. The presence of clinical assessment (5P) always means the necrosis of muscles and was the most serious or irreversible stage of ACS. Besides pressure methods, the threshold of pressure identifying ACS was also controversial.

Official Title
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Acute Compartment Syndrome

Conditions
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Acute Compartment Syndrome

Intervention / Treatment
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* Procedure: fasciotomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Fracture patients with Schatzker V and VI, Who were older than eighteen years. Exclusion Criteria: The exclusion criteria were pathologic, extra-articular proximal tibial fracture, Patients who was eighteen years or younger. Patients treated with other implant, underwent conservative management were also excluded.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| fractures with blister appeared<br>tibial plateau fractures with blister observed | Procedure: fasciotomy<br>* if it was suspected with ACS, the fasciotomy was conducted. but if the blister observed, it means decreased conmpartment sydrome. therefore, the blister observed can avoid unnecessary fasciotomy to patients suspected with ACS<br>|
| fractures without blister appeared<br>tibial plateau fractures without blister observed | Procedure: fasciotomy<br>* if it was suspected with ACS, the fasciotomy was conducted. but if the blister observed, it means decreased conmpartment sydrome. therefore, the blister observed can avoid unnecessary fasciotomy to patients suspected with ACS<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| injury mechanism | The relative data was collected about injury mechanism such as high falling accident, traffic accident, fall from standing height,Crushing | up to 1 weeks | 
| the time when the blister appeared | The relative data was collected about the time when the blister appeared after injury | up to 4 weeks | 
| time to reconstructive surgery | The relative data was collected about time to reconstructive surgery | time to when the surgery was conducted after 2 weeks | 
| union time | The relative data was collected about union time | through study completion, an average of 1 year | 
| No non-anatomic gap or step (larger than 5 mm) | The relative data was collected about complications | through study completion, an average of 1 year | 
| secondary loss of reduction | The relative data was collected about complications | through study completion, an average of 1 year | 
| Deep venous thrombosis | The relative data was collected about complications | through study completion, an average of 1 year | 
| superficial wound problems | The relative data was collected about complications | through study completion, an average of 1 year | 
| blister skin immunochemistry and immunofluorescence analysis | CK1, 5, 10, claudin 1, 2 and occludin as determined by immunochemistry analysis, and skin barrier proteins; claudin 1, 2 and occludin was determined by immunofluorescence analysis and qPCR. | through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| CK levels | CK levels | through hospitalization completion, an average of 1 month | 
| chloride levels | chloride levels | through hospitalization completion, an average of 1 month | 
| UREA levels | UREA levels | through hospitalization completion, an average of 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ACS, Tibial plateau fractures, Tibial shaft fractures