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Erschienen in: European Journal of Trauma and Emergency Surgery 3/2019

04.02.2019 | Original Article

Compartment pressures in children with normal and fractured lower extremities

verfasst von: Hannah Rachel Bussell, Christoph Alexander Aufdenblatten, Ulrike Subotic, Markus Kalisch, Georg Staubli, Daniel Max Weber, Sasha Sasha Tharakan

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 3/2019

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Abstract

Purpose

Needle manometry is a tool to confirm suspected acute compartment syndrome (ACS). There is scarce evidence of normal pressure values of the lower extremities in children. The aim of this study is to assess the normal compartment pressures in non-injured lower extremities of children.

Methods

This prospective study included children up to the age of 16 years with lower extremity fractures that needed reduction. Between June 2009 and August 2015, 20 children were included. We used needle manometry to measure the pressures in the superficial (SPC), deep posterior (DPC) and in the anterior compartments (AC) on both the lower legs.

Results

On the healthy leg, the mean compartment pressure was 15.15 mmHg in the AC (range 7–30 mmHg), 14.32 mmHg in the SPC (range 8–24 mmHg) and 13.00 mmHg in the DPC (range 4–21 mmHg). On the injured leg, the mean compartment pressure was 24.07 mmHg in the AC (range 5–40 mmHg), 17.21 mmHg in the SPC (range 7–29 mmHg) and 17.13 mmHg in the DPC (range 6–37 mmHg). We found a perfusion gradient (diastolic blood pressure—compartment pressure) < 30 mmHg in at least one compartment of the fractured and healthy leg in 13 patients. Five patients underwent fasciotomy for suspected ACS and their data was excluded for the injured leg.

Conclusion

We could show that children have higher normal compartment pressures than adults in the lower leg. They seem to be able to tolerate higher absolute compartment pressures and lower pressure gradients before ACS occurs. More studies are needed to make a final statement on tolerable compartment pressures in children.
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Metadaten
Titel
Compartment pressures in children with normal and fractured lower extremities
verfasst von
Hannah Rachel Bussell
Christoph Alexander Aufdenblatten
Ulrike Subotic
Markus Kalisch
Georg Staubli
Daniel Max Weber
Sasha Sasha Tharakan
Publikationsdatum
04.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 3/2019
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-019-01082-9

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