Osteofascial compartment pressure measurement in closed limb injuries - Whitesides' technique revisited.

Abstract

Regular monitoring of tissue compartmental pressures and hence a timely intervention in patients with impending compartment syndrome has been shown to prevent morbidity and permanent disability. Intra-compartmental pressure in flexor compartment of forearm and various compartments of legs following recent trauma presenting within 6h of injury was carried out in 30 subjects using Whitesides' technique and patients were classified into 3 categories for treatment purposes i.e., Category I: pressure <30mmHg, Category II: pressure 30-40mmHg and Category III: pressure >40mmHg. Category I had 17 subjects, Category II had 6 subjects whereas 7 subjects fell into Category III. 6 patients out of the 30 studied needed fasciotomy, out of which 5 had fair or good result. Whitesides' technique, though not much widely favoured, is a safe, inexpensive, easily assembled and reliable method for measurement of intra-compartmental pressure as a guide for decompression.