title: Interobserver Variability in the Measurement of Lower Leg Compartment Pressures.
abstract: OBJECTIVE
  To determine whether interobserver technical variations and errors in the measurement of compartment pressures may affect measurement accuracy.
  
  
  METHODS
  Four above-knee cadaveric specimens were used to create a consistent model of lower leg compartment syndrome. Thirty-eight physicians examined the limbs and measured 4 compartment pressures using the Intra-Compartmental Pressure Monitor (Stryker Orthopaedics). They were observed for correct assembly and use of the monitor. Measurements obtained were compared with known pressures.
  
  
  RESULTS
  Of the total number of compartment measurements, 31% were made using the correct technique, 39% were made with lesser errors in technique, and 30% were made with catastrophic errors. Only 60% of measurements made with the correct technique were within 5 mm Hg of the standard pressure. Accuracy dropped to 42% for measurements taken with small errors in technique and 22% when a catastrophic error was committed.
  
  
  CONCLUSIONS
  Variations in use of a commercially available pressure monitor exist, and errors are common. Proper use improved accuracy, but even with proper technique, 40% of the measurements were >5 mm Hg from the actual pressure. Based on our data, measurement accuracy with this device should be questioned and viewed within a range. Regular review and education of technique is strongly recommended.
authors.affiliation: *Orthopaedic Trauma Services, Mission Hospital, Asheville, NC; †Department of Orthopaedic Surgery and Sports Medicine, Harborview Medical Center, Seattle, WA; and ‡Rothman Institute at Thomas Jefferson University, Philadelphia, PA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Large
authors.forename: Julie
authors.initials: J
authors.lastname: Agel
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Holtzman
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Benirschke
authors.forename: James C
authors.initials: JC
authors.lastname: Krieg
mesh_terms: D002102:Cadaver; D003161:Compartment Syndromes; D006801:Humans; D007866:Leg; D008875:Middle Aged; D015588:Observer Variation; D009983:Orthopedic Equipment; D009985:Orthopedics / Q000379:methods*; D011312:Pressure; D015203:Reproducibility of Results