• OBJECTIVE
    • To test previously established radiographic predictors of compartment syndrome in tibial plateau fractures and determine whether novel measurements may further improve a surgeon's ability to identity patients at high risk for developing this outcome.
  • DESIGN
    • Retrospective review.
  • SETTING
    • Academic Level I trauma center.
  • PATIENTS
    • Five hundred thirteen patients with tibial plateau fractures treated operatively over a 10-year period (OTA/AO 41B1-3 & 41C1-3; Schatzker I-VI).
  • INTERVENTION
    • Previously established plain film radiographic measurements and novel computed tomography soft tissue measurements.
  • MAIN OUTCOME MEASURE
    • Acute compartment syndrome (ACS).
  • RESULTS
    • Schatzker VI fractures (odds ratio 5.72, confidence interval 2.55-12.83, P < 0.001), high-energy mechanism (3.10, 1.26-7.58, P = 0.0096), fibular fracture (8.14, 3.33-19.96, P < 0.0001), fracture length (9.70, 2.45-37.69, P = 0.0014), and plateau-shaft combined injury (2.97, 1.15-7.70, P = 0.019) were all associated with the development of compartment syndrome. The depth of the posterior compartment was also predictive of CS (1.06, 1.02-1.09, P = 0.0025). Patients with 3 and 4 predictive markers demonstrated a 20% and 27% chance of developing ACS respectively.
  • CONCLUSIONS
    • This study confirms that several factors are associated with the development of ACS. The presence of each independent predictor had a cumulative effect such that when more than one variable is present, the chance of ACS increases. This information may be used to alert providers regarding injuries that require vigilant evaluation.
  • LEVEL OF EVIDENCE
    • Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.