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Specialty Update   |    
What's New in Pediatric Orthopaedics
Young-Jo Kim, MD, PhD1; Kenneth J. Noonan, MD2
1 Children's Hospital-Boston, 300 Longwood Avenue, Hunnewell 225, Boston, MA 02115. E-mail address: young-jo.kim@childrens.harvard.edu
2 Department of Orthopaedics and Rehabilitation, University of Wisconsin, K4/732 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792-7375. E-mail address: noonan@orthorehab.wisc.edu
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Specialty Update has been developed in collaboration with the Board of Specialty Societies (BOS) of the American Academy of Orthopaedic Surgeons.

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Jun 01;92(6):1575-1582. doi: 10.2106/JBJS.J.00267
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Extract

Acute compartment syndrome associated with fractures or surgical procedures is anticipated and usually is treated appropriately and in a timely manner; however, it can occur even in cases not involving fractures, with devastating consequences. Prasarn et al.1 reported on fourteen cases of pediatric upper extremity compartment syndrome that occurred in the absence of fractures. In eight cases, the cause was iatrogenic (for example, intravenous fluid infiltration, drug infusion, or retention of a phlebotomy tourniquet). Ten of the twelve patients were being managed in the intensive-care unit because of other life-threatening disease or injury. Unfortunately, because of the delay in recognition of the problem and hence the delay in treatment, four amputations were necessary. The authors recommended increased vigilance among the staff managing children, especially in the intensive-care setting.
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