Does a pressure increase translate into an adjacent compartment? A cadaver study

Objectives:Theinfluenceoflocalpressureelevationontheadjacentcompartmentofthelowerlimbispoorlydescribed.Weexamined theseeffectsinanon-fracturedcadavermodel.Methods:Pairedlegsofunfrozenspecimenswereused.Thepressureintheanterior andintheperonealcompartmentofthecontralaterallimbwasraisedbybolusinjectionsofsaline(5ccbolus/60seconds.Pressure changes in the adjacent compartments were measured.Results: Pressure increase in the anterior and peroneal compartment, up to 100 mmHg did not affect the mean maximum pressure changes in the other compartments.Exceeding 100 mmHg in the anteriorcompartment,theperonealpressurewas13.67mmHg(range8-20mmHg),thedeepposterior7.50mmHg(5-13mmHg)andthesuperficialcompartmentpressurewas6.67mmHg(4-9mmHg).Incasesofraisedpressuresintheperonealcompartment above 100 mmHg, the anterior, deep and superficial posterior compartments showed pressures of 12.5 mmHg(11-15 mmHg), 7.5 mmHg(4-11mmHg),and7.5mmHg(4-12mmHg).Conclusions:Ourdatasuggestthatincreasedpressuresintheanteriortibial orperonealcompartmentsdonotdirectlyinfluencetheneighbouringcompartments.Itappearsthatinanintactcompartment,the fasciasealspressureelevationsintherangethatisclinicallyrelevant.Whetherornotthismayhaveclinicalimpactontheindications forsingleversusmultiplecompartmentfasciotomyshouldbesubjecttofurtherstudies.©VersitaSp.zo.o.

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