Monitoring dynamic anterior compartment pressures during exercise

Abstract

This report presents the early results of a new technique, using a solid-state transducer intracompartmental (STIC) catheter, developed to measure dynamic pressure changes in the anterior compartment of the leg in patients with exercise-induced anterior compartment syndrome. Nine male volunteers (15 limbs) with a history of exercise-induced anterior compartment pain were studied and compared to eleven asymptomatic male controls matched for age, weight and height. After catheter insertion, anterior compartment pressures were recorded with the subjects walking and running on a treadmill and performing several static maneuvers before and after the exercise period. The most statistically significant value between the two groups was the difference in mean pressure during running (P less than 0.001). Presently, all mean running pressures greater than 85 mm Hg are considered abnormal. This new technique offers the investigator the opportunity to measure dynamic intracompartmental pressures in symptomatic patients and provides an objective measurement for selection of patients for fasciotomy.

Diagnosis of chronic anterior compartment syndrome in the lower leg

“…Mean muscle pressures exceeding 50, 80, and 85 mm Hg during exercise have been used as criteria in diagnosing CCS (McDermott et al 1982, Puranen & Alavaikko 1981. We found no significant difference in MMP between painful and asymptomatic legs in unilateral CCS or between CCS and non-CCS patients (Table 3).…”

“…In all pressure studies of CCS, increased intramuscular pressure (IMP) at rest after exercise, and a prolonged time for normalization of the increase pressure have been used as criteria for the diagnosis (Reneman 1985). Recently, different IMP parameters during exercise have also been considered in the diagnosis of the syndrome, e.g., mean muscle pressure (Puranen 8c Alavaikko 1981), muscle contraction pressure (McDermott et al 1982), and muscle relaxation pressure, that is, the pressure in the relaxed muscle between contractions (Styf et al 1986).…”

Intramuscular pressures during exercise Comparison of measurements with and without infusion

“…Therefore, intramuscular pressure recordings during exercise and at rest after exercise are helpful in diagnosing the causes of exercise-induced pain in the lower legs. Pressure recordings during exercise are also useful in the study of ergonomics and in mechanical studies of muscle tissue ( Baumann et al 1979, Mubarak 1981, McDermott et al 1982, Komer et al 1984, Sejerstedt et al 1984.…”

Laser Doppler flowmetry in the diagnosis of chronic compartment syndrome

“…17,18 Despite this, because the pressure increases in normal subjects during exercise 7,8,10 there is no consensus as to the diagnostic criteria. The abnormal limits for the ICP have been variously defined as greater than 85 mmHg during exercise, 19 30 mmHg, 8,10 40 to 50 mmHg, 20 and 75 mmHg at the end of exercise. 21 The increase over resting pressure has also been used, 10 with values of 20 mmHg, 8 40 mmHg at five minutes of recovery, 21 or 15 mmHg after 15 minutes of recovery.…”