A prospective, randomized study of intramedullary nails inserted with and without reaming for the treatment of open and closed fractures of the tibial shaft.

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Abstract

[Indexed for MEDLINE] 17. J Am Acad Orthop Surg Glob Res Rev. 2025 Mar 11;9(3):e24.00100. doi: 10.5435/JAAOSGlobal-D-24-00100. eCollection 2025 Mar 1. Isolated Fibula Fracture With Development of Acute Compartment Syndrome. Bortman JM(1), Buchanan MW, Freccero DM. Author information: (1)From the Department of Orthopaedic Surgery, Boston Medical Center Pl, Boston, MA. Compartment syndrome is an orthopaedic emergency with moderate-to-severe sequela (pain, muscle contracture, nerve damage, infection, rhabdomyolysis, renal failure, etc.) if inadequately treated and can be difficult to diagnose in a timely fashion. Further complicating timely diagnosis are atypical presentations resulting in compartment syndrome. This case concerns a 31-year-old man who presented with isolated left closed transverse fibular shaft fracture after being a pedestrian struck by a high-speed motor vehicle. He was not on any anticoagulation at the time of the accident. Initial examination 1 hour after arrival was concerning for compartment syndrome because of firm lower extremity compartments, and intracompartmental pressures met criteria for the diagnosis of acute compartment syndrome. He was emergently taken for dual-incision, four-compartment fasciotomy 3 hours after arrival. This case report demonstrates a presentation of acute compartment syndrome in the absence of tibia fracture or risk factors such as anticoagulation. Clinical suspicion of acute compartment syndrome based on physical examination findings warrants close monitoring and possible compartment release even with atypical presentations such as an isolated fibula fracture, high-energy soft-tissue injuries, or crush injuries. Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons. DOI: 10.5435/JAAOSGlobal-D-24-00100 PMCID: PMC11902980