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The Journal of Bone and Joint Surgery, Vol 60, Issue 8 1091-1095, Copyright © 1978 by Journal of Bone and Joint Surgery, Inc
Acute compartment syndromes: diagnosis and treatment with the aid of the wick catheter
SJ Mubarak, CA Owen, AR Hargens, LP Garetto and WH Akeson
Intracompartmental pressures were measured by the wick catheter technique
in sixty-five compartments of twenty-seven patients who were clinically
suspected of having acute compartment syndromes. A pressure of thirty
millimeters of mercury or more was used as an indication for decompressive
fasciotomy. The range of normal pressure was from zero to eight millimeters
of mercury. Eleven of these patients were diagnosed as actually having
compartment syndromes and in these patients, twenty-seven compartments were
decompressed. Only two patients had significant sequelae. In the sixteen
patients (thirty-eight compartments) whose pressures remained less than
thirty millimeters of mercury, fasciotomy was withheld and compartment
syndrome sequelae did not develop in any patient. Intraoperatively the wick
catheter was used continuously in eight patients to document the
effectiveness of decompression. Fasciotomy consistently restored pressures
to normal except in the buttock and deltoid compartments, where
epimysiotomy was required to supplement the fasciotomy. Continuous
intraoperative monitoring of pressure by the wick catheter technique
allowed us to select the few cases in which primary closure of wounds was
appropriate and to decide which patients were best treated with secondary
closure.
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