Compartmental pressure in adults with tibial fracture

• Published in: International orthopaedics Vol. 29; no. 2; pp. 130 - 133
• Main Authors: Ogunlusi, Johnson D, Oginni, Lawrence M, Ikem, Innocent C
• Format: Journal Article
• Language: English
• Published: Germany Springer-Verlag 01.04.2005
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Compartment Syndromes - diagnosis; Compartment Syndromes - etiology; Compartment Syndromes - surgery; Decompression, Surgical; Fasciotomy; Female; Humans; Male; Middle Aged; Original Paper; Orthopedic Procedures - instrumentation; Orthopedic Procedures - methods; Prospective Studies; Tibial Fractures - complications; Treatment Outcome
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-004-0630-6

Acute compartment syndrome is associated with tibial fractures and failure to diagnose it leads to grave consequences. This study was conceived with the aim of determining the intra-compartmental pressure in adults with closed tibial fractures and intended to provide early diagnosis of acute compartment syndrome. The Whitesides injection method was used, using hospital [corrected] available materials. The intra-compartmental pressure in the anterior and deep posterior compartments of 52 patients with closed tibial fractures was measured at presentation and 4 hourly for 24 h. In three patients, the pressure was very high, and the differential pressure (i.e. the difference between the diastolic blood pressure and the intra-compartmental pressure) was less than or equal to [corrected] 30 mmHg, which was diagnostic of acute compartment syndrome. They were all treated by fasciotomy. It is concluded that Whitesides' [corrected] method can be used to diagnose acute compartment syndrome. The apparatus is easy to set up, cheap [corrected] and therefore ideal for use in our environment where sophisticated devices of tissue pressure measurement are not available.