What is the effect of compartment syndrome and fasciotomies on fracture healing in tibial fractures?

Acute compartment syndrome (ACS) in tibial diaphyseal fractures has been associated with such complications as infection, delayed fracture healing or non-union, sensory and motor deficits, deformities, and poor functional outcome. Essential condition of an uncomplicated recovery is early diagnosis with prompt decompression. A comprehensive review of the literature was performed to evaluate the impact of compartment syndrome and leg fasciotomies on the time to fracture union and the incidence of delayed union and non-union in tibial diaphyseal fractures. A total of 16 articles, which included 245 tibial fractures complicated with compartment syndrome were analysed. There were statistically significant differences in the time to healing, being longer by 4.90 weeks (p < 0.001), and in the rates of delayed union or non-union (55% versus 17.8%) (p < 0.001) when these fractures were compared to tibial fractures without compartment syndrome. Patients with ACS of the tibia undergoing leg fasciotomies should be informed about the increased risk of impaired fracture healing and longer time to union.