Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
6083658 | Injury | 2013 | 5 Pages |
ObjectiveWe investigated the ability of direct continuous measurement of intramuscular tissue oxygenation (PmO2) to detect acute ischaemia in the leg in patients at risk for acute extremity compartment syndrome. Following tibia fracture treated by intramedullary nailing, we compared the proportions of PmO2 and compartment pressure (CP) measurements that met the warning criteria for compartment syndrome.MethodsParticipants included 10 patients sustaining acute isolated closed tibia shaft fractures treated by intramedullary nailing. A tissue oxygenation probe and a CP probe were percutaneously placed into the anterior compartment of the leg. PmO2 and CP in the anterior compartment were measured in the injured leg for 48Â h postoperatively. Measurements meeting the warning criteria were defined as PmO2Â <Â 10Â mmHg, CPÂ >Â 30Â mmHg and perfusion pressure ÎPÂ <Â 30Â mmHg.ResultsNone of the patients developed compartment syndrome. Comparison of CP and PmO2 showed a CPÂ >Â 30Â mmHg in 50.39% of CP measurements in all patients and a PmO2Â <Â 10Â mmHg in 0.75% of PmO2 measurements in two patients (PÂ =Â 0.005). Comparison of ÎP and PmO2 showed a ÎPÂ <Â 30Â mmHg in 31.01% of ÎP measurements in nine patients and a PmO2Â <Â 10Â mmHg in 0.76% of PmO2 measurements in one patient (PÂ =Â 0.01).ConclusionIn the absence of compartment syndrome, pressure measurements following tibia fracture treated with intramedullary nailing often met the warning criteria, whereas PmO2 did not, suggesting that measurement of intramuscular tissue oxygenation may represent a potential method for the identification of acute compartment syndrome that deserves continued investigation.