Introduction We describe the correct technique for measuring compartment pressure with a handheld device to diagnose compartment syndrome.
Step 1: Device Preparation Proper preparation of the handheld pressure monitoring device (Stryker Surgical, Kalamazoo, Michigan) is critical to ensure that the device performs appropriately.
Step 2: Identification of the Compartment of Interest The needle must be placed in the proper location to appropriately measure a compartment’s pressure.
Step 3: Injection Inject saline solution from the pressure monitoring device to clear any soft tissue from the side port on the needle that could result in inaccurate pressure measurements.
Step 4: Stabilization and Pressure Reading The pressure must reach a stable state before it is recorded; different pressure thresholds for decompression have been recommended in the literature.
Step 5: Repeat Measurements As mistakes can be made with any single measurement, accuracy may be improved by repeating steps 1 through 4 and averaging the results.
Step 6: Additional Compartments After the reading is obtained, move on to any additional compartment(s) that need to be evaluated, repeating the steps listed above.
Results The handheld intracompartmental monitoring device with a side-ported needle has been shown to be extremely accurate in the laboratory.
Pitfalls & Challenges
We describe the correct technique for measuring compartment pressure with a handheld device to diagnose compartment syndrome.
Acute compartment syndrome is an orthopaedic emergency that requires accurate and timely diagnosis. Although compartment syndrome is often a clinical diagnosis, measurement of the compartment pressure can validate the clinician’s suspicion and provide objective data when the clinical picture is unclear. Handheld intracompartmental pressure monitors are often used to measure compartment pressures. Such devices are relatively simple to operate but proper technique is necessary to obtain accurate measurements. The proper technique (Video 1) is presented below.
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