Anterior Compartment Pressures Research Articles

Increase in Deltoid Compartment Pressures Immediately After Arthroscopic Rotator Cuff Repair Does Not Significantly Affect Postoperative Opioid Consumption

To investigate the association between changes in individual (anterior, lateral, and posterior) and overall deltoid compartment pressures and postoperative opioid consumption up to 14 days after primary double-row arthroscopic rotator cuff repair (ARCR). In 113 consecutive patients undergoing primary double-row ARCR, anterior, lateral, and posterior deltoid compartment pressures were measured prior to incision and immediately after closure with a manometer. Postoperatively, all patients were provided with an identical rehabilitation protocol, quantity and dose of opioid tablets, and pain journal in which to record daily opioid consumption and visual analog scale pain scores for 14 days after surgery. The pain journals were collected at the first postoperative visit, and opioid consumption was calculated based on morphine equivalents. Statistical analysis was performed to determine the association between deltoid compartment pressures and opioid consumption postoperatively. Sixty-nine percent of patients who met the inclusion criteria (74 of 107) returned the pain journals. The mean age at the time of surgery was 57.4 ± 8.8 years (range, 30-75 years), with female patients being significantly older (P= .03). The mean length of surgery was 71.7 ± 16.3 minutes. No significant association between increase in individual (anterior, lateral, or posterior) or mean overall compartment pressures and morphine equivalents of opioid consumption was appreciated on any postoperative day. No significant correlation between increase in individual or overall deltoid compartment pressures after ARCR and postoperative opioid consumption in the immediate postoperative period was found in this study. Level II, prospective cohort study.

Post-exercise leg compartment pressure measurements in asymptomatic collegiate distance runners: a prospective study

Background: Chronic exertional compartment syndrome (CECS) is an uncommon cause of leg pain in running athletes. Post-exercise compartment pressure measurements are an invasive test that many clinicians use for making the diagnosis of CECS. We sought to determine if intracompartmental pressures in anterior leg compartments of asymptomatic collegiate distance runners meet established criteria for diagnosis of exertional compartment syndrome. Methods: Thirty collegiate running athletes underwent 1-minute post-exercise compartment pressure measurements of bilateral anterior leg compartments. Each was asked to run for 15 min at a moderately intense pace, and then underwent measurements performed at 1-minute postexertion with a needle manometer. Fifteen male and 15 female collegiate running athletes from age 18 to 23 yr (average 20.8 yr) underwent post-exercise compartment pressure testing of the legs. Results: Eleven (six men, five women) demonstrated 1-minute post-exercise compartment pressure measurements that met criteria for diagnosis of exertional compartment syndrome in at least one leg based on established criteria (>30 mmHg). Of these 11, four demonstrated positive measurements bilaterally (two men, two women). Intracompartmental pressure measurements ranged from 16 mmHg to 88 mmHg (average 27.5 mmHg). Measurements of anterior leg compartments performed at 1-minute post-exercise were indicative of exertional compartment syndrome in more than one-third of the asymptomatic running athletes tested (11/30, 36.7%). Conclusions: Elevated anterior leg compartment pressures were prevalent in collegiate distance runners despite a lack of symptoms. Post-exercise compartment pressure measurements should be viewed only as an indicator of exertional compartment syndrome and not relied upon as a confirmatory test. Level of Evidence: Level IV.

Arthroscopic Treatment of Osteochondral Lesions of the Talus in a Suspended Position With the Patient in a Prone Position.

The purpose of this study was to evaluate the clinical results and the safety of arthroscopic microfracture with the ankle suspended on a shoulder-holding traction frame for simultaneous anterior and posterior ankle arthroscopy in the prone position. Between May 2010 and January 2016, 31 patients with posterior osteochondral lesions of the talus (OLTs) were treated with arthroscopic microfracture in a suspended position with the patient prone. Ankle distraction was achieved by suspending the affected ankle on a shoulder-holding traction frame. The 100 mm visual analog scale (VAS) and the Foot Function Index (FFI) were checked preoperatively and at final follow-up. Postoperative complications related to the suspended position were analyzed. Lower leg intramuscular compartment pressure was checked after the surgery to determine if there was any risk of compartment syndrome. The mean 100-mm VAS score, and FFI improved from 62.8 ±11.3 and 48.5 ± 12.1, respectively, preoperatively to 15.8 ± 10.4 and 16.4 ± 9.2, respectively, at final follow-up (P = .025, and P = .005, respectively). The mean anterior, lateral, superficial posterior, and deep posterior compartment pressures were 7.3 ± 1.5, 8.1 ± 1.1, 5.6 ± 1.9, and 9.2 ± 2.4 mmHg, respectively. No compartment syndrome occurred. Arthroscopic treatment of OLT in a prone position with the ankle suspended on a shoulder-holding traction frame allowed the use of simultaneous anterior and posterior portals for viewing and instrumentation without major operative complications, such as compartment syndrome. Level IV, retrospective case series.

Management of Chronic Exertional Compartment Syndrome and Fascial Hernias in the Anterior Lower Leg With the Forefoot Rise Test and Limited Fasciotomy

Chronic exertional compartment syndrome can present either as anterolateral lower leg pain or as painful muscle herniation. If an athlete or a soldier wants to continue training, there is no proven effective nonoperative treatment, and fasciotomy of 1 or more of the lower leg muscle compartments is usually recommended. Our clinical protocol differs from most reported ones in the use of the forefoot rise test to increase pressure and provoke pain and our recommending minimal surgery of the anterior compartment only. We present results of surgery based on our clinical management flowchart. Patients who had surgery during a 12-year period were reviewed by telephone interview or office examination. Pain was graded from 0 (none) to 4 (unbearable). Preoperative resting and exercise anterior compartment pressures were evaluated in most subjects before and immediately following a repeated weight-bearing forefoot rise test. Surgery was under local anesthesia, limited to the anterior compartment only and percutaneous (excepting muscle hernias). There were 36 patients, mean age 24 years. Of 16 patients who were originally operated unilaterally, 5 patients were later operated on the other side. Mean presurgery resting pressure was 56 mm Hg (40-80 mm Hg) rising to 87 mm Hg (55-150 mm Hg) with exercise. Mean exercise pain score dropped from 2.9 presurgery to 1.3 postsurgery (n = 35, P < .0001). Complications included superficial peroneal nerve injury (3 legs in 3 patients, 1 requiring reoperation). When we used our clinical management flowchart based on the forefoot rise test, percutaneous fasciotomy of the anterior compartment alone provided good clinical results. Care must be taken to prevent injury to the superficial peroneal nerve in the distal lower leg. Level IV, retrospective case series.

The Utility of Ultrasound in Detecting Anterior Compartment Thickness Changes in Chronic Exertional Compartment Syndrome

To test the hypothesis that patients with chronic exertional compartment syndrome (CECS) of the anterior leg compartment have an increased anterior compartment thickness (ACT) compared with control subjects after exertion using ultrasound. Prospective comparison study. Diagnostic imaging department of a tertiary care hospital. Four patients with CECS and 9 control subjects. Patients with CECS and control subjects ran on a treadmill for up to 10 minutes. Anterior compartment thickness (both groups) and anterior compartment pressure (CECS patients) were measured before exertion and at scheduled intervals after exertion. Anterior compartment thickness, percentage change in ACT from rest, and compartment pressure. Anterior compartment pressures were diagnostic of CECS using the modified Pedowitz criteria in patients with CECS. Mean percentage change in ACT from rest in patients with CECS versus control subjects at 0.5 minutes was 21.3% versus 6.32% [95% confidence interval (CI), 6.92-35.6 and 0.094-12.5, respectively; P = 0.011]; at 2.5 minutes, it was 24.6% versus 4.22% (95% CI, 10.7-38.5 and -1.85-10.3, respectively; P = 0.003); and at 4.5 minutes, it was 24.9% versus 5.08% (95% CI, 14.3-35.5 and -0.813-11.0, respectively; P = 0.003). Mean ACT in patients with CECS versus control subjects significantly increased after exertion (P = 0.003) at 0.5 minutes, 2.5 minutes, and 4.5 minutes. Ultrasonography reveals a significant increase in ACT in patients with CECS of the anterior leg compartment. Further studies are warranted to validate these findings with the goal of developing anterior leg compartment CECS ultrasound diagnostic criteria and exploring the role of using ultrasound to diagnose CECS in other compartments.

Characteristics of Patients With Chronic Exertional Compartment Syndrome

Chronic exertional compartment syndrome (CECS) is a condition that causes reversible ischemia and lower extremity pain during exercise. To date there are few large studies examining the characteristics of patients with CECS. This study aimed to present these characteristics by examining the largest published series of patients with a confirmed diagnosis of the disorder. An IRB-approved, retrospective review was undertaken of patients with a suspected diagnosis of CECS undergoing pre- and postexercise compartment pressure testing between 2000 and 2012. Patients were evaluated for gender, age, duration of symptoms, pain level, specific compartments involved, compartment pressure measurements, and participation and type of athletics. Two-hundred twenty-six patients (393 legs) underwent compartment pressure testing. A diagnosis of CECS was made in 153 (67.7%) patients and 250 (63.6%) legs with elevated compartment measurements; average age of the patients was 24 years (range, 13-69 years). Female patients accounted for 92 (60.1%) of those with elevated pressures. Anterior and lateral compartment pressures were elevated most frequently, with 200 (42.5%) and 167 (35.5%) compartments, respectively. One hundred forty-one (92.2%) patients reported participation in sports, with running being the most common individual sport and soccer being the most common team sport. Duration of pain prior to diagnosis averaged 28 months. Although there is ample literature pertaining to the diagnostic criteria and treatment algorithm of the condition, few papers have described the type of patient most likely to develop CECS. This is the largest study to date to evaluate the type of patient likely to present with chronic exertional compartment syndrome. Level III, retrospective review.

Forefoot Running Improves Pain and Disability Associated With Chronic Exertional Compartment Syndrome

Background: Anterior compartment pressures of the leg as well as kinematic and kinetic measures are significantly influenced by running technique. It is unknown whether adopting a forefoot strike technique will decrease the pain and disability associated with chronic exertional compartment syndrome (CECS) in hindfoot strike runners. Hypothesis: For people who have CECS, adopting a forefoot strike running technique will lead to decreased pain and disability associated with this condition. Study Design: Case series; Level of evidence, 4. Methods: Ten patients with CECS indicated for surgical release were prospectively enrolled. Resting and postrunning compartment pressures, kinematic and kinetic measurements, and self-report questionnaires were taken for all patients at baseline and after 6 weeks of a forefoot strike running intervention. Run distance and reported pain levels were recorded. A 15-point global rating of change (GROC) scale was used to measure perceived change after the intervention. Results: After 6 weeks of forefoot run training, mean postrun anterior compartment pressures significantly decreased from 78.4 ± 32.0 mm Hg to 38.4 ± 11.5 mm Hg. Vertical ground-reaction force and impulse values were significantly reduced. Running distance significantly increased from 1.4 ± 0.6 km before intervention to 4.8 ± 0.5 km 6 weeks after intervention, while reported pain while running significantly decreased. The Single Assessment Numeric Evaluation (SANE) significantly increased from 49.9 ± 21.4 to 90.4 ± 10.3, and the Lower Leg Outcome Survey (LLOS) significantly increased from 67.3 ± 13.7 to 91.5 ± 8.5. The GROC scores at 6 weeks after intervention were between 5 and 7 for all patients. One year after the intervention, the SANE and LLOS scores were greater than reported during the 6-week follow-up. Two-mile run times were also significantly faster than preintervention values. No patient required surgery. Conclusion: In 10 consecutive patients with CECS, a 6-week forefoot strike running intervention led to decreased postrunning lower leg intracompartmental pressures. Pain and disability typically associated with CECS were greatly reduced for up to 1 year after intervention. Surgical intervention was avoided for all patients.

Right Calf Pain - Football

HISTORY: 17 year-old Caucasian male and high school football linebacker presents to our sports medicine office with right lateral calf pain after sustaining a helmet to his R lateral lower leg the previous day. He was also injured 2 weeks prior, when he developed a contusion in the same region after a helmet struck his lower leg. PHYSICAL EXAMINATION: In the office, he was unable to bear weight on his right leg due to pain. Examination showed decreased right posterior tibialis pulse 1+, mottled skin changes to right distal leg and foot, decreased sensation over right foot, and increased 1.5 cm calf circumference, pain with palpation over R lateral calf, decreased dorsiflexion of his R foot, decreased capillary refill (3-4 seconds), distal R foot cooler to palpation compared to L. DIFFERENTIAL DIAGNOSIS: Acute compartment syndrome, Contusion, Myositis ossificans, DVT, Tibia/fibula fracture TEST AND RESULTS: Lab evaluation with pressure manometry showed elevated anterior (67), lateral (55) and deep posterior (58) compartment pressures (values in mmHg) were noted in our office. Xray of R Tibia/Fibula revealed oblique proxmial fibula. FINAL WORKING DIAGNOSIS: Acute Compartment Syndrome TREATMENT AND OUTCOMES: Patient was transferred to orthopedic care for emergency fasciotomy procedure that day and had skin graft closure 4 days later. Subsequently, he was also diagnosed with an oblique fracture of the proximal fibula prior to surgery. He is continuing to recover from his surgery, able to bear weight 2 weeks post surgery and will be starting physical therapy.

Anterior compartment pressure measurement in closed fractures of leg

Background:Compartment syndrome is a potentially devastating condition. Increased intracompartmental pressure has been incriminated as the primary pathogenic factor in compartment syndrome. The purpose of this prospective study was to monitor the anterior compartmental pressure and differential pressure to minimize the incidence of acute compartment syndrome.Materials and Methods:Seventy-five consecutive cases of closed fractures of leg presenting within six hours of injury were taken for measurement of anterior compartment pressure at the level of fracture and at 5 cm and 10 cm away from the fracture site, using the Whitesides' infusion technique. A differential pressure of less than 30 mm Hg was taken as the criterion for diagnosis of compartment syndrome.Results:Two patients (2.67%) developed acute compartment syndrome. The mean anterior compartment pressures were highest at the level of the fracture and went on decreasing as we went away from the fracture site, which was found to be statistically significant (P < 0.001).Conclusion:Compartment pressure measurement is the most reliable and objective method for early diagnosis of compartment syndrome. Whitesides' infusion technique is a relatively easy and inexpensive method to come to a diagnosis of compartment syndrome in a developing country like India. Differential pressure is more reliable than absolute pressure in predicting the development of an impending compartment syndrome.

Elevation in Compartment Pressure Following Hypovolemic Shock and FluidResuscitation: A Canine Model

We induced hemorrhagic shock in seven dogs and then resuscitated them with intravenous (IV) lactated ringers. We then monitored anterior leg compartment pressures via a slit catheter during both bleeding and reperfusion. These values were compared with controls that received IV fluids without being bled. Compartment pressures in resuscitated dogs rose well above control values. These values were statistically significant when compared to controls via the paired student t test (P < .01). This model demonstrates that sufficient swelling occurs to significantly elevate compartment pressures, even in the absence of local trauma. While this elevation may not be sufficient enough to cause a compartment syndrome, it reinforces the notion that extremities that have experienced ischemia and reperfusion are at an increased risk for developing compartment syndrome.

Pneumatic Compression Boots, Lithotomy Stirrups, and Lower Limb Compartment Syndrome

We are grateful to Drs. Turnbull and Mills for noting a number of factors to consider when discussing the issue of perioperative compartment syndrome that is not associated with obvious etiologic factors, such as thromboembolic or traumatic arterial or venous occlusions. This problem is indeed quite rare. 1The combined rarity of the event and the multiple, potential contributing factors make it very difficult to draw conclusions about etiologic factors. Therefore, we believe it is best to perform studies to elucidate isolated factors before drawing any comprehensive conclusions.Our study specifically focused on the effects of a sequential pneumatic compression device on pressures in the tibialis anterior muscle compartment of awake volunteers in the lithotomy position. 2We found that the use of the compression device decreased intracompartmental pressures, making no comment about its effects on intracompartmental blood flow. Yes, Chase et al. 3have very nicely shown that anterior leg compartment pressures increase when anesthetized patients are placed in the 45° lithotomy position with consistent use of Allen supports and sequential compression devices, especially for prolonged periods. Their study, however, does not address our question about the effects of the compression device on intracompartmental pressures and is irrelevant to our study.Lower extremity arterial and venous blood flow and many other factors likely affect perfusion and oxygenation of the muscles of the leg compartments. Therefore, we agree with Drs. Turnbull and Mills that it would be premature to conclude that sequential pneumatic compression devices minimize the risk of developing lower extremity compartment syndrome. However, these devices appear to decrease pressures in the anterior tibialis muscle compartment, a finding that contrasts with common (and unproved) wisdom.

Intraoperative lower extremity compartment pressures in lithotomy-positioned patients

Measurement of anterior leg compartment pressures in eight patients (16 limbs) who were positioned in the lithotomy position for prolonged periods of time while undergoing colorectal intra-abdominal surgery. Anterior leg compartment pressures were measured in eight patients (16 limbs) by using a slit catheter, whereas subjects were positioned in the lithotomy position for prolonged periods of time while undergoing colorectal intra-abdominal surgery. Compartment pressures had minor elevations after initial lithotomy positioning, and gradually increased over time. Levels elevated to 30 mmHg at an average of five (range, 3.5 to 6) hours. The maximum recorded leg compartment pressure was 70 mmHg. The addition of Trendelenburg positioning was noted to consistently increase compartment pressures. All pressures returned to less than 10 mmHg shortly after removing the limb from the stirrups and placing the limb supine. No patients developed clinical evidence of compartment syndrome. Leg anterior compartment pressures rise when limbs are placed in the lithotomy position for prolonged periods of time. The rise in pressure is increased with the addition of Trendelenburg positioning. Anterior compartment pressures reached a threshold of 30 mmHg at an average of five hours. The results of this study suggest that lithotomy positioning of the lower extremities has the potential to initiate leg compartment syndrome when the period of positioning approaches five hours. Removing the limbs from the stirrups and placing them in the supine position allows the pressure in the compartments to return to normal.

Compartment Pressure Monitoring During Anterior Cruciate Ligament Reconstruction

Summary: A prospective double blind randomized study was carried out using 20 healthy males with anterior cruciate ligament (ACL) insufficiency undergoing bone–patellar tendon–bone ACL reconstruction. The subjects were randomized into either water or saline irrigation and then underwent identical reconstructive procedures using an arthroscopic pump. Continuous preoperative, intraoperative, and postoperative pressures were monitored using the slit catheter technique. Blood pressure and compartment pressure measurements were continuously recorded and noted at all stages of the procedure. Mean preoperative anterior and posterior compartment pressures were similar in both groups. No significant differences were noted between the anterior and posterior compartments of each group. No difference between water and saline irrigation was identified throughout the procedure. In both groups, postoperative pressures were slightly lower in the anterior and posterior compartments compared with preoperative pressures, but not significantly.Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 15, No 6 (July), 1999: pp 607–612

Treatment of chronic exertional anterior compartment syndrome with massage: a pilot study.

To determine the effect of massage on anterior chronic exertional compartment syndrome (CECS) with respect to symptoms, intracompartmental pressures, and work output of the anterior compartment in dorsiflexion. One group-repeated measures design. A private sports medicine clinic in Melbourne, Australia. Seven athletes (six men and one woman), aged between 21 and 29 years, were selected on the basis of clinical suspicion for anterior CECS. Historical questionnaire and examination were followed by intracompartmental pressure testing of the anterior compartment. Study exclusion criteria were history of a bleeding diathesis and previous treatment consisting of compartment fasciotomy or massage. All athletes completed the study. A 5-week course of massage consisting of two sessions in the first week and one session per week thereafter, for a total of six treatments. Between each session, a twice-daily standard stretching program involving both anterior and posterior compartments was performed. Postexercise anterior compartment pressures (mm Hg) before and after treatment, work output (J) in dorsiflexion to pain onset before and after treatment, self-reported symptoms before and after treatment. There was no significant difference in the 3-minute postexercise compartment pressures after the treatment. There was a significant (p = 0.016) increase, however, in work performed in dorsiflexion to pain onset following the massage course. Intermittent massage combined with specific stretching should be considered in the treatment of anterior CECS.

The effects of simulated Bier block IVRA on intracompartmental tissue pressure.

Intravenous regional anesthesia (IVRA) is a useful anesthetic method for closed reduction of fractures. However, IVRA has been associated with an increased incidence of compartment syndrome when treating tibial shaft fractures. The purpose of this study was to measure changes in anterior leg compartment pressures during simulated IVRA. A volunteer study was performed. An indwelling catheter placed in a consistent location between subjects was used to measure tissue pressure. A vinyl leg splint was used for exsanguination followed by thigh tourniquet inflation (300 mmHg). Normal saline (1.5 mL/kg) was injected through the greater saphenous vein (1.0 mL/s). Pressure measurements were obtained before and after tourniquet inflation, at 10 mL increments during saline injection, and intermittently after volume injection with the tourniquet inflated, then deflated. There was no significant difference in tissue pressure before (2.4 +/- 2.2 mmHg) and after (4.3 +/- 3.7 mmHg) tourniquet inflation (P = 0.11). No significant difference in tissue pressure were found as a function of injected volume (P = 0.62), as a function of time following saline injection during tourniquet inflation (P = 0.08), and after tourniquet deflation (P = 0.16). We conclude that in the normal atraumatic limb, simulated IVRA using normal saline does not increase tissue pressure within the anterior leg compartment.

Anterior tibial compartment pressures during intermittent sequential pneumatic compression therapy.

We studied the anterior tibial compartment pressures during the application of a JOBST sequential intermittent pneumatic compression device on 5 healthy human volunteers (10 legs). Intracompartmental pressures were measured using a slit catheter. The measurements of interstitial pressures were highest at maximal calf inflation, and pressures were increased for approximately 120 seconds during each cycle. Pressure measurements in the inflated pressure sleeve varied less than 10% with the measured anterior tibial compartment pressures during intermittent pneumatic compression therapy. This intermittent pneumatic compression device may elevate intramuscular pressure significantly above that necessary to render muscle ischemic. However, these periods of pressure elevation are not long enough to produce any significant adverse effects, and the beneficial effects of decreased edema fluid may be safely realized.

Effect of the pneumatic antishock garment on intramuscular pressure

Recent case reports implicate pneumatic antishock garment (PASG) usage in subsequent development of compartment syndromes. The anterior tibial compartment pressures of eight healthy volunteers were selected for study at varying PASG inflation pressures. A wick catheter method provided continual intramuscular compartment pressure (IMP) monitoring throughout the period of study. A linear correlation between PASG pressure and IMP exists, with more than 90% of the externally applied pressure being transmitted to the muscle compartment. All subjects developed IMP greater than 50 mm Hg at PASG inflation of 60 mm Hg. Externally applied pressure appears to create a condition that may stimulate or lead to a compartment syndrome. Inflation pressure should be monitored closely during PASG application, because IMP can be assumed to be at least as high as inflation pressure. The lowest effective PASG pressure should be used.

The measurement of dynamic compartment pressure during exercise.

Anterior tibial compartment pressures have been examined during exercise in nine healthy university students. Six male and three female subjects weighing 140 to 160 pounds and between 18 and 25 years of age were tested. A slit catheter was introduced into the muscle belly of the subjects' right anterior tibial compartment and dynamic compartment pressures measured using an F.M. telemetry system. Subjects were exercised on a treadmill at speeds from 1 to 6 mph and the variations in compartment pressure during one exercise cycle (one stride length) and over the course of the exercise period examined. Results have shown that both average and peak to peak pressures measured during exercise are much higher than those recorded at rest, and compartment pressures rose with increasing speed.

Reference values for intramuscular pressure in the lower leg in man

Intramuscular pressures in the anterior tibial and superficial posterior compartments of the lower leg were measured by the wick catheter technique in 34 healthy individuals (17 males and 17 females, mean age 42 years). The pressures were measured at rest, during and after exercise and during venous and arterial occlusion. The pressure was 1.1 (range 0.3-3.0) kPa in the anterior tibial and 0.5 (range 0.0-2.0) kPa in the superficial posterior compartment at rest. During exercise the intramuscular pressures rose to 3.5 (range 1.0-8.0) kPa and 0.9 (range 0.1-2.8) kPa respectively. The anterior tibial compartment pressures were lower in females than in males at exercise and lower in older than in younger persons at rest. After exercise the pressures were back to the pre-exercise levels within 5 min. Venous occlusion caused an increase in the pressure which was more marked in the anterior tibial compartment than in the superficial posterior compartment. Arterial occlusion did not cause any dramatic changes in intramuscular pressures, but there was a slight elevation during the period of reactive hyperaemia.

Monitoring dynamic anterior compartment pressures during exercise. A new technique using the STIC catheter.

This report presents the early results of a new technique, using a solid-state transducer intracompartmental (STIC) catheter, developed to measure dynamic pressure changes in the anterior compartment of the leg in patients with exercise-induced anterior compartment syndrome. Nine male volunteers (15 limbs) with a history of exercise-induced anterior compartment pain were studied and compared to eleven asymptomatic male controls matched for age, weight and height. After catheter insertion, anterior compartment pressures were recorded with the subjects walking and running on a treadmill and performing several static maneuvers before and after the exercise period. The most statistically significant value between the two groups was the difference in mean pressure during running (P less than 0.001). Presently, all mean running pressures greater than 85 mm Hg are considered abnormal. This new technique offers the investigator the opportunity to measure dynamic intracompartmental pressures in symptomatic patients and provides an objective measurement for selection of patients for fasciotomy.