Timing of Presentation of Pediatric Compartment Syndrome and Its Microsurgical Implication: A Retrospective Review
Bibliographic record
Abstract
BACKGROUND: Pediatric forearm compartment syndrome can lead to severe functional disability. Although it is known that earlier presentation with decompression leads to better outcomes, it is not known when presentation after injury leads to significant loss of function requiring microsurgical intervention. The authors describe the rate of microsurgical reconstruction after pediatric forearm compartment syndrome as related to timing of presentation. METHODS: A retrospective chart review was conducted of pediatric patients with forearm compartment syndrome between January 1, 2000, and March 22, 2013, after a traumatic upper extremity injury. Demographic information, cause, time to decompression, complications, and functional outcome were recorded. RESULTS: Thirty-five patients aged between 2 and 16 years (8.97 ± 4.12 years) met inclusion criteria. The majority (74 percent) were boys. The right upper extremity was predominantly involved (54 percent), with a predilection for ulnar fractures (66 percent). Fasciotomies were completed for 32 patients (91 percent). Two patients had no decompression (6 percent) because of late presentation. The average time to fasciotomy was less than 12 hours after injury in 16 patients (46 percent), 12 to 48 hours in 15 patients (43 percent), and greater than 48 hours in four patients (11 percent). Complications (63 percent) included nerve injury (40 percent), skin graft (37 percent), scar revision (11 percent), and long flexor tightness requiring serial casting (17 percent). Forearm muscle necrosis requiring microsurgical reconstructive surgery with a gracilis muscle flap occurred in two patients (6 percent). Increased time to decompression was statistically associated with long flexor tightness and gracilis reconstructive surgery. CONCLUSION: Presentation after 48 hours resulted in significant functional deficits requiring reconstructive surgery (gracilis muscle flap reconstruction) or long-term conservative management (serial casting).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".