Pre- and postsurgery measurements of continuous muscle compartment pressure in patients with extremity trauma

BACKGROUND: Continuous pressure measurement of traumatized muscle has been shown to be an accurate method of diagnosing acute compartment syndrome (ACS), but no baseline data have been released to show the reaction to surgery in extremity fracture. We sought to establish normal values for perioperative pressures. METHOD: We obtained pressure tracings from prospective clinical trials of forearm and tibia fractures requiring surgery. We standardized data and produced graphs using the ggplot2 library in R version 4.2.2. We generated generalized pressure curves based on the mean pressure and quantile distribution for each time point. RESULTS: We retrieved data from 79 preoperative and 50 postoperative patients. The mean age was 43 years in both groups. Patients exhibited higher pressures postoperatively whether or not they developed ACS. In both the preoperative and postoperative ACS groups, muscle pressure trended upward at an average rate of 0.078 and 0.073 mmHg per hour, respectively, but trended downward in non-ACS groups, at a rate of 0.24 and 0.27 mm Hg per hour pre- and postoperatively, respectively. Patients younger than 45 years registered the highest initial postoperative pressure. Postoperative initial pressures were higher than preoperative pressures and were higher among males than females. Females had steeper decreasing pressure curves in both pre- and postoperative scenarios. CONCLUSION: We observed trends in muscle pressure by sex, age, and diagnosis of ACS among trauma patients. Understanding these variations is essential for improving timely diagnosis of ACS.