[The significance of intracompartmental pressure values for the diagnosis of chronic functional compartment syndrome. A meta-analysis of research studies of pressures in anterior M. tibialis during exercise stress].
BACKGROUND
The chronic exertional compartment syndrome of the musculus tibialis anterior is thought to be responsible for a major part of complaints of the lower leg among active sportsmen. There is an important role of tissue pressure measurement in diagnosing chronic anterior compartment syndrome during muscular activity. However, there is a controversial debate about the relevant parameters.


METHODS
Metaanalysis of all the 21 studies (1979-1998) measuring intracompartmental pressures during muscular activity. Parameters of analysis: type of exercise, catheter technique, recommendations of diagnostic criteria.


RESULTS
Analysis of literature shows that there has been no standardisation concerning the type of muscular exertion (isometrics for 5-10 min, exercise on the treadmill between 3.2 and 12 km/h). In 8 of the 21 studies the results have been attained through the unsuitable Wick-catheter-technique. In the overall view none of the suggested criterions for diagnosis is taken up by other teams. There are considerable variations up to 500% regarding the recommended parameters.


CONCLUSIONS
From all studies no uniform recommendation for parameters of diagnostic relevance can be derived. On this background it should be demanded that future research is conducted by a uniform regimen for examination and modern technique of measuring with a high temporal resolution. Under these standardised conditions the investigated parameters of the intracompartmental pressure curve should be reconsidered once more regarding diagnostic predictability by calculations of specifity and sensitivity.
Willy
C
C
Abteilung Chirurgie, Bundeswehrkrankenhaus, Ulm.
Sterk
J
J
Völker
H U
HU
Benesch
S
S
Gerngross
H
H
D000328:Adult; D000868:Anterior Compartment Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D005080:Exercise Test / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology / Q000503:physiopathology*; D005082:Physical Exertion; D011312:Pressure; D012015:Reference Standards; D012680:Sensitivity and Specificity