Is there a compartmental pressure transfer in lower limb fractures?
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Limb fractures provoke elevated compartment pressures at the fracture site. This study investigates the pressure influence to adjacent compartments in cases of closed fractures.
Paired lower limbs were used to simulate elevated pressures with and without fracture in a volume-controlled cadaveric model. Pressure increase was induced by saline infusion to a maximum pressure of 200 mmHg. The resultant pressure changes of all adjacent compartments (peroneal, deep and superficial posterior) were recorded simultaneously using handheld needle pressure measurement.
Six pairs of specimens were evaluated. The mean volume of saline infusion resulted in a significant volume increase in the fractured limbs compared with the anterior compartment of the control group (p<0.05). The pressure response in the affected anterior compartments was similar in the fractured and in the non-fractured limb. Adjacent compartment pressures did not increase noticeably even at high pressure levels.
Elevated pressure simulation after closed fracture of the lower limb does not substantially affect the adjacent compartments compared with that of the non-fractured limb. The measurement of all compartments may be indicated to accurately assess indications of fasciotomy.
KeywordsAcute compartment syndrome Pressure measurement Monitoring Cadaveric tibia shaft fracture
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