Simultaneous 4 Compartment Pressure Monitoring in Diagnosis of Chronic Exertional Compartment Syndrome of the Forearm

Abstract

The authors describe a technique for bilateral simultaneous measuring of forearm compartments pressure for assessment of suspected chronic exertional compartment syndrome of the forearm. Under ultrasound guidance, 18-G cannulae were inserted bilaterally into the superficial flexor and dorsal extensor forearm compartments. The imaging was used to confirm safe subfascial placement, and ensured no kinking or catching on the muscle bellies during dynamic movements. An arterial pressure transducer with 4 portals allowed simultaneous measurements from 4 compartments. Intracompartmental pressure (ICP) was measured in 2 ways, (1) hand in a relaxed position and (2) power grip with Jamar Dynamometer. After baseline measurements were taken, the patient undertook a period of rowing sufficient to generate symptoms. ICPs were then recorded at 1, 2, and 5 minutes by which time symptoms had resolved. Using this method ICPs in 4 myofascial compartments was measured in the same limb, simultaneously, pre- and postexercise.