Applicability of devices available for the measurement of intracompartmental pressures: a cadaver study
Abstract Purpose The indication for surgical treatment of the chronic exertional compartment syndrome is evaluated by measuring intracompartmental pressures. The validity of these invasive intracompartmental pressure measurements are increasingly questioned in the absence of a standardized test prot...
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| Format: | Article |
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Wiley
2022-01-01
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| Series: | Journal of Experimental Orthopaedics |
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| Online Access: | https://doi.org/10.1186/s40634-022-00529-0 |
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| author | Sanne Vogels Ewan D. Ritchie Djuna deVries Gert‐Jan Kleinrensink Michiel H. J. Verhofstad Rigo Hoencamp |
| author_facet | Sanne Vogels Ewan D. Ritchie Djuna deVries Gert‐Jan Kleinrensink Michiel H. J. Verhofstad Rigo Hoencamp |
| author_sort | Sanne Vogels |
| collection | DOAJ |
| description | Abstract Purpose The indication for surgical treatment of the chronic exertional compartment syndrome is evaluated by measuring intracompartmental pressures. The validity of these invasive intracompartmental pressure measurements are increasingly questioned in the absence of a standardized test protocol and uniform cut‐off values. The aim of the current study was to test compartment pressure monitors and needles for uniformity, thereby supporting the physician’s choice in the selection of appropriate test materials. Methods A compartment syndrome was simulated in embalmed above‐knee cadaveric leg specimen. Four different terminal devices (Compass manometer, Stryker device, Meritrans transduce, and arterial line) were tested with 22 different needle types. Legs were pressurized after introduction of the four terminal devices in the anterior compartment, using the same needle type. Pressure was recorded at a 30‐second interval for 11 minutes in total. Before and after pressurization, the intravenous bag of saline was weighed. Results The simulation of a compartment syndrome resulted in intracompartmental pressure values exceeding 100 mmHg in 17 of the 22 legs (77%). In the other five legs, a smaller built‐up of pressure was seen, although maximum intracompartmental pressure was in between 70 and 100 mmHg. The intraclass correlation coefficient was above 0.700 for all possible needle types. Excellent to good resemblance was seen in 16 out of 22 instrumental setups (73%). The mean volume of saline infusion required in runs that exceeded 100 mmHg (309 ± 116 ml) was significantly lower compared to the legs in which 100 mmHg was not achieved (451 ± 148 ml; p = 0.04). Conclusion The intracompartmental pressure recordings of the four terminal devices were comparable, when tested with a standardized pressurization model in a human cadaver model. None of the included terminal devices or needle types were found to be superior. The results provide evidence for more diverse material selection when logistic choices for intracompartmental pressure measurement devices are warranted. Level of evidence Level IV. |
| format | Article |
| id | doaj-art-be9935e8894a49eea1275fad2071d17d |
| institution | DOAJ |
| issn | 2197-1153 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-be9935e8894a49eea1275fad2071d17d2025-08-20T03:07:37ZengWileyJournal of Experimental Orthopaedics2197-11532022-01-0191n/an/a10.1186/s40634-022-00529-0Applicability of devices available for the measurement of intracompartmental pressures: a cadaver studySanne Vogels0Ewan D. Ritchie1Djuna deVries2Gert‐Jan Kleinrensink3Michiel H. J. Verhofstad4Rigo Hoencamp5Department of SurgeryAlrijne HospitalSimon Smitweg 12353LeiderdorpGAThe NetherlandsDepartment of SurgeryAlrijne HospitalSimon Smitweg 12353LeiderdorpGAThe NetherlandsDepartment of SurgeryAlrijne HospitalSimon Smitweg 12353LeiderdorpGAThe NetherlandsDepartment of NeuroscienceErasmus Medical CenterRotterdamthe NetherlandsTrauma Research UnitDepartment of Trauma SurgeryErasmus Medical CenterRotterdamthe NetherlandsDepartment of SurgeryAlrijne HospitalSimon Smitweg 12353LeiderdorpGAThe NetherlandsAbstract Purpose The indication for surgical treatment of the chronic exertional compartment syndrome is evaluated by measuring intracompartmental pressures. The validity of these invasive intracompartmental pressure measurements are increasingly questioned in the absence of a standardized test protocol and uniform cut‐off values. The aim of the current study was to test compartment pressure monitors and needles for uniformity, thereby supporting the physician’s choice in the selection of appropriate test materials. Methods A compartment syndrome was simulated in embalmed above‐knee cadaveric leg specimen. Four different terminal devices (Compass manometer, Stryker device, Meritrans transduce, and arterial line) were tested with 22 different needle types. Legs were pressurized after introduction of the four terminal devices in the anterior compartment, using the same needle type. Pressure was recorded at a 30‐second interval for 11 minutes in total. Before and after pressurization, the intravenous bag of saline was weighed. Results The simulation of a compartment syndrome resulted in intracompartmental pressure values exceeding 100 mmHg in 17 of the 22 legs (77%). In the other five legs, a smaller built‐up of pressure was seen, although maximum intracompartmental pressure was in between 70 and 100 mmHg. The intraclass correlation coefficient was above 0.700 for all possible needle types. Excellent to good resemblance was seen in 16 out of 22 instrumental setups (73%). The mean volume of saline infusion required in runs that exceeded 100 mmHg (309 ± 116 ml) was significantly lower compared to the legs in which 100 mmHg was not achieved (451 ± 148 ml; p = 0.04). Conclusion The intracompartmental pressure recordings of the four terminal devices were comparable, when tested with a standardized pressurization model in a human cadaver model. None of the included terminal devices or needle types were found to be superior. The results provide evidence for more diverse material selection when logistic choices for intracompartmental pressure measurement devices are warranted. Level of evidence Level IV.https://doi.org/10.1186/s40634-022-00529-0Compartment pressureChronic Exertional compartment syndromeManometersNeedlesCompartment pressure monitor |
| spellingShingle | Sanne Vogels Ewan D. Ritchie Djuna deVries Gert‐Jan Kleinrensink Michiel H. J. Verhofstad Rigo Hoencamp Applicability of devices available for the measurement of intracompartmental pressures: a cadaver study Journal of Experimental Orthopaedics Compartment pressure Chronic Exertional compartment syndrome Manometers Needles Compartment pressure monitor |
| title | Applicability of devices available for the measurement of intracompartmental pressures: a cadaver study |
| title_full | Applicability of devices available for the measurement of intracompartmental pressures: a cadaver study |
| title_fullStr | Applicability of devices available for the measurement of intracompartmental pressures: a cadaver study |
| title_full_unstemmed | Applicability of devices available for the measurement of intracompartmental pressures: a cadaver study |
| title_short | Applicability of devices available for the measurement of intracompartmental pressures: a cadaver study |
| title_sort | applicability of devices available for the measurement of intracompartmental pressures a cadaver study |
| topic | Compartment pressure Chronic Exertional compartment syndrome Manometers Needles Compartment pressure monitor |
| url | https://doi.org/10.1186/s40634-022-00529-0 |
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