Laser Doppler flowmetry in the diagnosis of chronic compartment syndrome

Ábrahám, Pierre; Lefthériotis, Georges; Saumet, J. L.

doi:10.1302/0301-620x.80b2.7963

Cited by 47 publications

(6 citation statements)

References 22 publications

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“…A noninvasive diagnosis of chronic compartment syndrome can be made by measuring variations in the level of muscle hemoglobin and myoglobin oxygen saturation by near-infrared spectroscopy 10 and continuous measurement of the laser Doppler flow in muscles. 11 Alternatively, the pressure-distribution measurement system, BIG-MAT ® (Nitta, Osaka, Japan), is a noninvasive method to measure external pressure (EP) for industrial applications. 12 In our previous studies, we have used the BIG-MAT ® system in the medical field to measure EP in certain fibular regions to investigate the cause of common peroneal nerve paralysis using the KCLH system in the lithotomy position.…”

Section: Introductionmentioning

confidence: 99%

Male sex, height, weight, and body mass index can increase external pressure to calf region using knee-crutch-type leg holder system in lithotomy position

Mizuno¹,

Takahashi²

2016

TCRM

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BackgroundWell-leg compartment syndrome (WLCS) is one of the catastrophic complications related to prolonged surgical procedures performed in the lithotomy position, using a knee-crutch-type leg holder (KCLH) system, to support the popliteal fossae and calf regions. Obesity has been implicated as a risk factor in the lithotomy position-related WLCS during surgery. In the present study, we investigated the relationship between the external pressure (EP) applied to the calf region using a KCLH system in the lithotomy position and selected physical characteristics.MethodsTwenty-one young, healthy volunteers (21.4±0.5 years of age, eleven males and ten females) participated in this study. The KCLH system used was Knee Crutch®. We assessed four types of EPs applied to the calf region: box pressure, peak box pressure, contact pressure, and peak contact pressure, using pressure-distribution measurement system (BIG-MAT®). Relationships between these four EPs to the calf regions of both lower legs and a series of physical characteristics (sex, height, weight, and body mass index [BMI]) were analyzed.ResultsAll four EPs applied to the bilateral calf regions were higher in males than in females. For all subjects, significant positive correlations were observed between all four EPs and height, weight, and BMI.ConclusionEP applied to the calf region is higher in males than in females when the subject is supported by a KCLH system in the lithotomy position. In addition, EP increases with the increase in height, weight, and BMI. Therefore, male sex, height, weight, and BMI may contribute to the risk of inducing WLCS.

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Section: Introductionmentioning

confidence: 99%

Male sex, height, weight, and body mass index can increase external pressure to calf region using knee-crutch-type leg holder system in lithotomy position

Mizuno¹,

Takahashi²

2016

TCRM

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“…Among the nine remaining studies, two studies reported promising results regarding a noninvasive diagnostic test (Supplementary Table 5 ) 10 37 . These two studies showed that laser doppler flow has a different time course in CECS 37 , and that Korotkoff sounds were more persistent in the tibialis anterior artery in CECS 10 . Subsequent studies confirming these findings were not identified using our search strategy.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Innovative Diagnostic Tests for Chronic Exertional Compartment Syndrome

et al. 2022

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The diagnosis chronic exertional compartment syndrome is traditionally linked to elevated intracompartmental pressures, although uncertainty regarding this diagnostic instrument is increasing. The aim of current review was to evaluate literature for alternative diagnostic tests. A search in line with PRISMA criteria was conducted. Studies evaluating diagnostic tests for chronic exertional compartment syndrome other than intracompartmental pressure measurements were included. Bias and quality of studies were evaluated using the Oxford Levels of Evidence and the QUADAS-2 instrument. A total of 28 studies met study criteria (MRI n=8, SPECT n=6, NIRS n=4, MRI and NIRS together n=1, miscellaneous modalities n=9). Promising results were reported for MRI (n = 4), NIRS (n = 4) and SPECT (n = 3). These imaging techniques rely on detecting changes of signal intensity in manually selected regions of interest in the muscle compartments of the leg. Yet, diagnostic tools and protocols were diverse. Moreover, five studies explored alternative modalities serving as an adjunct, rather than replacing pressure measurements. Future research is warranted as clinical and methodological heterogeneity were present and high quality validation studies were absent. Further optimization of specific key criteria based on a patient’s history, physical examination and symptom provocation may potentially render intracompartmental pressure measurement redundant.

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“…Studies show similarity between the various methods for measuring intracompartmental pressure 8 , 9 , 10 . According to McQueen et al (7) , monitoring of patients who presented a difference in the compartmental pressure and diastolic blood pressure ≤30 mmHg showed normal muscle function, even without compartmental release.…”

Section: Compartment Syndromementioning

confidence: 86%

Tibial Shaft Fractures

Kojima

Ferreira

2011

Revista Brasileira de Ortopedia (English Edition)

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The long-bone fractures occur most frequently in the tibial shaft. Adequate treatment of such fractures avoids consolidation failure, skewed consolidation and reoperation. To classify these fractures, the AO/OTA classification method is still used, but it is worthwhile getting to know the Ellis classification method, which also includes assessment of soft-tissue injuries. There is often an association with compartmental syndrome, and early diagnosis can be achieved through evaluating clinical parameters and constant clinical monitoring. Once the diagnosis has been made, fasciotomy should be performed. It is always difficult to assess consolidation, but the RUST method may help in this. Radiography is assessed in two projections, and points are scored for the presence of the fracture line and a visible bone callus. Today, the dogma of six hours for cleaning the exposed fracture is under discussion. It is considered that an early start to intravenous antibiotic therapy and the lesion severity are very important. The question of early or late closure of the lesion in an exposed fracture has gone through several phases: sometimes early closure has been indicated and sometimes late closure. Currently, whenever possible, early closure of the lesion is recommended, since this diminishes the risk of infection. Milling of the canal when the intramedullary nail is introduced is still a controversial subject. Despite strong personal positions in favor of milling, studies have shown that there may be some advantage in relation to closed fractures, but not in exposed fractures.

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Laser Doppler flowmetry in the diagnosis of chronic compartment syndrome

Cited by 47 publications

References 22 publications

Male sex, height, weight, and body mass index can increase external pressure to calf region using knee-crutch-type leg holder system in lithotomy position

Male sex, height, weight, and body mass index can increase external pressure to calf region using knee-crutch-type leg holder system in lithotomy position

Systematic Review of Innovative Diagnostic Tests for Chronic Exertional Compartment Syndrome

Tibial Shaft Fractures

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