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Compartment Syndrome of the Leg After Treatment of a Femoral Fracture with an Early Sitting Spica CastA Report of Two Cases
Thomas M. Large, MD1; Steven L. Frick, MD1
1 Department of Orthopaedic Surgery, Carolinas Medical Center, P.O. Box 32861, Charlotte, NC 28232-2861. E-mail address for S.L. Frick: steven.frick@carolinashealthcare.org
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The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitale or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at the Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2003 Nov 01;85(11):2207-2210
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Extract

Compartment syndrome results from elevated tissue pressure within an osseofascial compartment that is caused either by an increase in the contents of the compartment, such as that produced by an accumulation of blood or other fluids, or by a decrease in the volume of the compartment, such as that occurring after the application of a constrictive cast or dressing1,2. The pathophysiology of compartment syndrome is well defined: as compartment pressure rises above arteriolar pressure, capillary flow decreases while venous outflow is obstructed, thus impairing perfusion to compartment structures1. Permanent losses of neural and muscular function are the feared outcomes. Compartment syndromes occur most frequently after lower-extremity trauma, often after a high-energy injury. We report the cases of two children in whom compartment syndrome of the leg developed after a low-energy fracture of the femoral shaft was treated with an early sitting spica cast. The parents of both children were informed that data concerning their cases would be submitted for publication.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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