title: Intracompartmental pressure changes after anterolateral bridge plating of tibial fractures.
abstract: OBJECTIVE
  Compartment syndrome is one of the most devastating complications in orthopedics both for the patient and the treating physician. Among the many causes, trauma and its treatment are the most common reasons for compartment syndrome, which most frequently occurs in the lower leg following tibial fractures. Since bridge plating of difficult metadiaphyseal tibial fractures is becoming increasingly popular, serious concerns have been raised about the increased intracompartmental pressures and possible compartment syndrome.
  
  
  METHODS
  This study investigated the intracompartmental pressure changes in anterolateral compartment of the leg during and immediately after anterolateral bridge plating of tibial fractures. Intracompartmental pressures were measured before and during plate application, just after the completion of fixation, and immediately and 4-5 min after the tourniquet release in 22 isolated closed comminuted tibial fractures.
  
  
  RESULTS
  Baseline anterolateral compartment pressures were higher than those on the uninjured side (9.3 vs 27.8 mmHg). Pressures were 69.5, 57.4, 65.8, and 56.8 mmHg, respectively, for the other measurements times. None of the patients received prophylactic fasciotomy, and none developed clinical compartment syndrome.
  
  
  CONCLUSIONS
  We found that anterolateral compartmental pressures were higher than pressures on the uninjured side in all patients. Although there is a considerable increase in intracompartmental pressures during and immediately after anterolateral percutaneous bridge plating of comminuted tibial fractures, intraoperative prophylactic fasciotomy is not routinely needed. One should monitor the patients on the first postoperative day for signs of compartment syndrome. Fasciotomy decisions should be based on both clinical symptoms and serial intracompartmental pressure measurements rather than a single measurement.
authors: Private Güven Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey. bulentdaglar@gmail.com.
authors: Bülent
authors: B
authors: Dağlar
authors: American Hospital, Department of Orthopaedics and Traumatology, Tirana, Albania.
authors: Önder Murat
authors: ÖM
authors: Delialioğlu
authors: American Hospital, Department of Orthopaedics and Traumatology, Tirana, Albania.
authors: Kenan
authors: K
authors: Bayrakcı
authors: Kulu State Hospital, Department of Orthopaedics and Traumatology, Konya.
authors: Kerem
authors: K
authors: Tezel
authors: Pamukkale University Faculty of Medicine, Department of Orthopaedics and Traumatology, Denizli, Turkey.
authors: Uğur
authors: U
authors: Günel
authors: Turkish Republic Ministry of Labour and Social Security, Social Security Institute, Ankara, Turkey.
authors: Erman
authors: E
authors: Ceyhan
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D001860:Bone Plates / Q000009:adverse effects*; D003161:Compartment Syndromes / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D042241:Early Diagnosis; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D013978:Tibial Fractures / Q000175:diagnosis / Q000601:surgery; D061665:Time-to-Treatment; D014421:Turkey