The Journal of Bone and Joint Surgery 79:844-9 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.
Intramuscular Deoxygenation during Exercise in Patients Who Have Chronic Anterior Compartment Syndrome of the Leg*
L. RANDALL MOHLER, M.D. ,
JORMA R. STYF, M.D., PH.D. ,
ROBERT A. PEDOWITZ, M.D., PH.D.,
ALAN R. HARGENS, PH.D. and
DAVID H. GERSHUNI, M.D., SAN DIEGO, CALIFORNIA
Investigation performed at University of California at San Diego, San Diego
Currently, the definitive diagnosis of chronic compartment syndrome is based on invasive measurements of intracompartmental pressure. We measured the intramuscular pressure and the relative oxygenation in the anterior compartment of the leg in eighteen patients who were suspected of having chronic compartment syndrome as well as in ten control subjects before, during, and after exercise. Chronic compartment syndrome was considered to be present if the intramuscular pressure was at least fifteen millimeters of mercury (2.00 kilopascals) before exercise, at least thirty millimeters of mercury (4.00 kilopascals) one minute after exercise, or at least twenty millimeters of mercury (2.67 kilopascals) five minutes after exercise. Changes in relative oxygenation were measured with use of the non-invasive method of near-infrared spectroscopy.
In all patients and subjects, there was rapid relative deoxygenation after the initiation of exercise, the level of oxygenation remained relatively stable during continued exercise, and there was reoxygenation to a level that exceeded the pre-exercise resting level after the cessation of exercise. During exercise, maximum relative deoxygenation in the patients who had chronic compartment syndrome (mean relative deoxygenation [and standard error], -290 ± 39 millivolts) was significantly greater than that in the patients who did not have chronic compartment syndrome (-190 ± 10 millivolts) and that in the control subjects (-179 ± 14 millivolts) (p < 0.05 for both comparisons). In addition, the interval between the cessation of exercise and the recovery of the pre-exercise resting level of oxygenation was significantly longer for the patients who had chronic compartment syndrome (184 ± 54 seconds) than for the patients who did not have chronic compartment syndrome (39 ± 19 seconds) and the control subjects (33 ± 10 seconds) (p < 0.05 for both comparisons).
CLINICAL RELEVANCE: Patients who had chronic anterior compartment syndrome of the leg had greater relative deoxygenation during exercise as well as delayed reoxygenation after exercise; these findings support an ischemic etiology for chronic compartment syndrome. Near-infrared spectroscopy may be useful as a non-invasive diagnostic tool for the evaluation of patients suspected of having chronic anterior compartment syndrome of the leg.
 CiteULike  Connotea  Del.icio.us  Facebook  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
M. S. Shuler, W. M. Reisman, T. E. Whitesides Jr., T. L. Kinsey, E. M. Hammerberg, M. G. Davila, and T. J. Moore
Near-Infrared Spectroscopy in Lower Extremity Trauma
J. Bone Joint Surg. Am.,
June 1, 2009;
91(6):
1360 - 1368.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. G. H. van den Brand, T. Nelson, E. J. M. M. Verleisdonk, and C. van der Werken
The Diagnostic Value of Intracompartmental Pressure Measurement, Magnetic Resonance Imaging, and Near-Infrared Spectroscopy in Chronic Exertional Compartment Syndrome: A Prospective Study in 50 Patients
Am. J. Sports Med.,
May 1, 2005;
33(5):
699 - 704.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T D A Barbour, C A Briggs, S N Bell, C J Bradshaw, D J Venter, and P D Brukner
Histology of the fascial-periosteal interface in lower limb chronic deep posterior compartment syndrome
Br. J. Sports Med.,
December 1, 2004;
38(6):
709 - 717.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. F. Pell IV, H. S. Khanuja, and G. R. Cooley
Leg Pain in the Running Athlete
J. Am. Acad. Ortho. Surg.,
November 1, 2004;
12(6):
396 - 404.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. G. H. van den Brand, E. J. M. M. Verleisdonk, and C. van der Werken
Near Infrared Spectroscopy in the Diagnosis of Chronic Exertional Compartment Syndrome
Am. J. Sports Med.,
March 1, 2004;
32(2):
452 - 456.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J. Fraipont and G. J. Adamson
Chronic Exertional Compartment Syndrome
J. Am. Acad. Ortho. Surg.,
July 1, 2003;
11(4):
268 - 276.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. J. Leversedge, P. J. Casey, J. G. Seiler III, and J. W. Xerogeanes
Endoscopically Assisted Fasciotomy : Description of Technique and In Vitro Assessment of Lower-Leg Compartment Decompression
Am. J. Sports Med.,
March 1, 2002;
30(2):
272 - 278.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. A. Schepsis, S. S. Gill, and T. A. Foster
Fasciotomy for Exertional Anterior Compartment Syndrome: Is Lateral Compartment Release Necessary?
Am. J. Sports Med.,
July 1, 1999;
27(4):
430 - 435.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
