Dr. Edward J. Harvey on Assessing Pressure Using Measurements from a Single Compartment
I commonly get asked, ‘How do you know you’re going to catch acute compartment syndrome if you only measure one compartment?’ My answer: ‘Because we have investigated the relationship between the compartments and you only need to measure one to see a trend in all compartments.’
A few years ago, we evaluated the relationship between compartments by isolating and pressurizing individual compartments. We had a pressure sensor in each compartment of the leg for the study.
We infused compartments in fresh frozen cadaver legs with saline – filling them sequentially in different order for each leg. The MY01 device was used to monitor pressure trends in both fluid-filled and non-fluid-filled compartments.
Here’s what we found:
- Compartments are related; when one is infused, pressure in all the others increases.
- There is a strong relationship between the anterior and lateral compartments.
- The deep posterior and superficial posterior compartments show a relationship as well
Once fasciotomies were performed, all four intracompartmental pressures decreased to levels below the ACS threshold. In fact, the deep posterior compartment dropped in pressure without fasciotomy when the other three compartments were released.
Our results can be found in the May 4, 2022 issue of The Journal of Bone and Joint Surgery (104(9):p 813-820, May 4, 2022. DOI: 10.2106/JBJS.21.00291).