Compartment pressure in nailed tibial fractures. A threshold of 30 mmHg for decompression gives 29% fasciotomies.
During the past few years we have monitored tissue pressure in patients treated with intramedullary nailing of tibial shaft fractures. A value of 30 mmHg has been used as the threshold for fasciotomy. The purpose of this study was to evaluate this practice. Sixty-three patients were included in the series. Forty-three fractures were closed, 18 grade I (Gustilo) and two grade II. Tissue pressure measurements were performed in 43 patients. Eighteen legs were treated with decompressive fasciotomy, three on clinical findings alone, and 15 after measurement of a pressure higher than 30 mmHg. This gives a fasciotomy rate of 29%. At follow-up two patients were dead. All fractures were healed, and there were no major complications such as deep infection, extensive muscle necrosis, paresis or short-foot syndrome. Three fasciotomized patients had significantly reduced muscle strength compared with the contralateral leg.
Ovre
S
S
Orthopaedic Department, Ullevål Hospital, Oslo, Norway.
Hvaal
K
K
Holm
I
I
Strømsøe
K
K
Nordsletten
L
L
Skjeldal
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003161:Compartment Syndromes / Q000175:diagnosis / Q000517:prevention & control; D019299:Decompression, Surgical; D005205:Fascia / Q000503:physiopathology; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary; D005596:Fractures, Closed / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D011312:Pressure; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000503:physiopathology / Q000601:surgery*