Intracompartmental pressure changes after anterolateral bridge plating of tibial fractures
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Tarih
2016
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Turkish Assoc Orthopaedics Traumatology
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Objective: Compartment syndrome is one of the most devastating complications in orthopedics both for the patient and the treating physician. Among the many causes, trauma and its treatment are the most common reasons for compartment syndrome, which most frequently occurs in the lower leg following tibial fractures. Since bridge plating of difficult metadiaphyseal tibial fractures is becoming increasingly popular, serious concerns have been raised about the increased intracompartmental pressures and possible compartment syndrome. Methods: This study investigated the intracompartmental pressure changes in anterolateral compartment of the leg during and immediately after anterolateral bridge plating of tibial fractures. Intracompartmental pressures were measured before and during plate application, just after the completion of fixation, and immediately and 4-5 min after the tourniquet release in 22 isolated closed comminuted tibial fractures. Results: Baseline anterolateral compartment pressures were higher than those on the uninjured side (9.3 vs 27.8 mmHg). Pressures were 69.5, 57.4, 65.8, and 56.8 mmHg, respectively, for the other measurements times. None of the patients received prophylactic fasciotomy, and none developed clinical compartment syndrome. Conclusion: We found that anterolateral compartmental pressures were higher than pressures on the uninjured side in all patients. Although there is a considerable increase in intracompartmental pressures during and immediately after anterolateral percutaneous bridge plating of comminuted tibial fractures, intraoperative prophylactic fasciotomy is not routinely needed. One should monitor the patients on the first postoperative day for signs of compartment syndrome. Fasciotomy decisions should be based on both clinical symptoms and serial intracompartmental pressure measurements rather than a single measurement.
Açıklama
Anahtar Kelimeler
Bridge plating, compartment syndrome, intracompartmental pressure, tibial fracture
Kaynak
Acta Orthopaedica Et Traumatologica Turcica
WoS Q Değeri
Q4
Scopus Q Değeri
Cilt
50
Sayı
1
Künye
Dağlar, B., Delialioğlu, Ö. M., Bayrakcı, K., Tezel, K., Günel, U., & Ceyhan, E. (2016). Intracompartmental pressure changes after anterolateral bridge plating of tibial fractures. Acta orthopaedica et traumatologica turcica, 50(1), 37–41.
