title: The thickness of the anterior compartment does not indicate compartment syndrome in acutely traumatised legs?
abstract: BACKGROUND
  The study was conducted to achieve early detection of increased compartment pressure by comparing the changes between the thickness and pressure within the musculofascial compartments after lower leg injury.
  
  
  METHODS
  We included cases of a lower-leg fracture between January and December 2007. Bilateral lower leg compartment pressure and thickness were measured before the surgery and post-anaesthesia, and the surgery was performed within 12 h after the initial trauma. The intracompartment pressure (ICP) was measured with a Wick catheter pressure monitor. The thickness (width) of the anterior compartment of lower leg was measured using ultrasound.
  
  
  RESULTS
  All data were measured within 4-6h of the injury. The average thickness in injured legs versus uninjured was 30 mm (15-46 mm) versus 20.4 mm (13-30 mm), P<0.001. The average intracompartment pressure (ICP) in injured leg versus uninjured was 45.3 mmHg (26-80 mmHg) versus 17.5 mmHg (15-20 mmHg), P<0.001. The thickness and ICP were significantly increased for injured lower legs compared to the uninjured legs, but the increase in ICP did not show a significant relationship with the change in thickness of the injured lower leg.
  
  
  CONCLUSIONS
  In this study, the results of ICP and thickness changes of injury lower leg compared with uninjured leg revealed no statistically significant correlation. Some injuries showed a high ICP with only mild changes in thickness, while some showed a high ICP with significant changes. Although ultrasound has many advantages for the evaluation of soft tissue changes after trauma, this study revealed that thickness changes are not a predicable parameter for determining pressure on the acute fracture of lower leg.
authors.affiliation: Department of Orthopaedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Sheng-Hao
authors.initials: SH
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Kun-Yi
authors.initials: KY
authors.lastname: Lin
authors.affiliation: Department of Orthopaedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Jui-Jung
authors.initials: JJ
authors.lastname: Yang
authors.affiliation: Department of Orthopaedics, Cardinal Tien Hospital, Taiwan. Electronic address: ortchang@gmail.com.
authors.forename: Jen-Huei
authors.initials: JH
authors.lastname: Chang
authors.affiliation: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Guo-Shu
authors.initials: GS
authors.lastname: Huang
authors.affiliation: Department of Orthopaedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Leou-Chyr
authors.initials: LC
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000868:Anterior Compartment Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D042241:Early Diagnosis; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007869:Leg Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011312:Pressure; D011379:Prognosis; D014463:Ultrasonography
keywords: Intracompartment pressure (ICP); Thickness; Ultrasound