Highlights
- •Readily available ultrasound technology can be used to detect elevated muscle compartment pressures.
- •Pressure used to generate deformity (flattening) of the fascial planes, in comparison to the uninvolved extremity, may be the best index to use.
- •The manuscript demonstrates proof of concept on the anterior leg compartment that needs to be validated on other compartments and clinically.
Abstract
Introduction: Acute compartment syndrome (ACS) is a limb-threatening condition often
associated with leg injury. The only treatment of ACS is fasciotomy with the purpose
of reducing muscle compartment pressures (MCP). Patient discomfort and low reliability
of invasive MCP measurements, has led to the search for alternative methods. Our goal
was to test the feasibility of using ultrasound to diagnose elevated MCP.
Methods: A cadaver model of elevated MCPs was used in 6 cadaver legs. An ultrasound
transducer was combined with a pressure sensing transducer to obtain a B-mode image
of the anterior compartment, while controlling the amount of pressure applied to the
skin. MCP was increased from 0 to 75 mmHg. The width of the anterior compartment (CW)
and the pressure needed to flatten the bulging superficial compartment fascia (CFFP)
were measured.
Results: Both the CW and CFFP showed high correlations to MCP in the individual cadavers.
Average CW and CFFP significantly increased between baseline and the first elevated
MCP states. Both Inter-observer and intra-observer agreements for the ultrasound measurements
were good to excellent.
Discussion: Ultrasound indexes showed excellent correlations in compartment pressures,
suggesting that there is a potential for the clinical use of this modality in the
future.
Keywords
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Article info
Publication history
Published online: January 14, 2019
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© 2019 Elsevier Ltd. All rights reserved.
