Practical Review on the Contemporary Diagnosis and Management of Compartment Syndrome

Davidson, Amelia L.; Sutherland, Mason A.; Siska, Robert C.; Janis, Jeffrey E.

doi:10.1097/gox.0000000000005637

Cited by 2 publications

(2 citation statements)

References 55 publications

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“…They obtained values that showed that the average hemoglobin oxygen saturation increased by 15.4% in the compartments of the anatomical segment with fracture injuries as compared to the contralateral limb and healthy subjects. More recent studies [14,27,28] have aimed to objectify the perfusion deficit by using NIR spectroscopy in acute compartment syndrome located at the level of the calf. In all of these patients, invasive determination of the intracompartmental pressure as well as spectroscopic measurement of the contralateral intact leg were performed.…”

Section: Discussionmentioning

confidence: 99%

An Innovative Non-Invasive Method for Early Detection and Monitoring of Acute Compartment Syndrome

Tepordei,

Zamfir,

Nedelcu

et al. 2024

JPM

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Background: Acute compartment syndrome is a major surgical emergency with complex pathophysiology and a highly unpredictable pattern of evolution. We hypothesized that the onset of acute compartment syndrome of the leg or forearm is associated with variations in the surface temperature of the distal segment (foot or hand) with a distinct pattern, which acts as an early warning sign. Materials and Methods: We developed a monitoring device that consists of two thermic sensors attached to a modular limb splint, which continuously measure the temperature difference between the proximal and distal regions of the limb (i.e., arm–hand, thigh–foot). Firstly, we investigated both the arm–hand and thigh–foot temperature gradients of hospitalized patients’ healthy limbs (43 patients, 56 upper limbs, 64 lower limbs) in order to establish a baseline. Secondly, we examined the correlation between the thermic gradients and intracompartmental pressure values in compartment syndrome limbs (20 patients, 6 upper limbs, 14 lower limbs). Results: For the control group, the mean values for the normal limb thermic gradients were −0.17 °C for the upper limbs. and 0.03 °C for the lower limbs. In the impending compartment syndrome group (defined by intracompartmental pressure values), the mean index was −0.38 °C. In the fully developed compartment syndrome group, the mean value was 4.11 °C. Discussions: Analysis was performed using the ANOVA one-way statistical method. This showed significant differences between the compartment syndrome group and the impending and control groups. A decreasing trend in the thermic gradient in patients with impending compartment syndrome compared with the control group was noted. Conclusions: The thermic gradient of limbs presenting signs of impending compartment syndrome decreases as a result of the increased temperature of the distal segment. This pattern can be used as an early diagnostic method for acute compartment syndrome. This technique is non-invasive and bears no risk to the patient, allowing facile continuous monitoring during immobilization.

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Section: Discussionmentioning

confidence: 99%

An Innovative Non-Invasive Method for Early Detection and Monitoring of Acute Compartment Syndrome

Tepordei,

Zamfir,

Nedelcu

et al. 2024

JPM

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show abstract

“…Re-examinations at shorter intervals are recommended as they may overlook significant findings. Follow-up visits should include an interview, physical examination with the removal of Sheene fixation, and, if necessary, quantitative ACS diagnostic tests such as Stryker needle, near-infrared spectroscopy (NIRS), ultrasound, and laboratory findings (creatine phosphokinase, creatinine, and urine myoglobin) should be performed [9].…”

Section: Discussionmentioning

confidence: 99%