Rapid Measurement of Compartment Pressure — A New Technique

Abstract

Compartment syndrome requires early diagnosis and prompt treat ment to minimize permanent se quelae. The diagnosis is suspected and most often made on clinical grounds alone. Symptoms and find ings include: (1) pain out of propor tion to the severity of the injury and unrelieved by immobilization, (2) sensory deficit distal to the compart ment related to nerves that course through the compartment, (3) pain on passive stretching of muscles in the involved compartment, and (4) tenseness and tenderness to palpation over the compartment. Frequently a clinical situation arises in which these criteria are con sidered invalid. The examination of a frightened, uncooperative child may be inadequate or unreliable. Simi larly, trauma patients who are intoxi cated or have head injuries may be difficult to examine. It may be impos sible to delineate neuropraxia from the compartment syndrome versus primary nerve injury (ie, brachial plexus injury). In these situations an objective measurement of the actual compartment pressure is essential. This paper describes a simple modifi cation of the standard needle-ma nometer method of measuring com partment pressure. By use of this modification, the pressure can be simply and rapidly measured with equipment available in most, if not all, hospital wards and emergency rooms.