Experimental evaluation of the effect of raised pressure in a single compartment in the lower leg on neighbouring compartments using fresh above knee amputated legs-a study of interstitial pressures with two case reports.

Abstract

Experimental evaluation of intracompartmental pressures in a fresh above knee amputated human leg. To determine what effect raised pressure in one compartment of the lower leg had upon its neighbour. There has been no previous reports of isolated compartment pathology, following low velocity trauma, causing a compartment syndrome in all four compartments of the lower leg. Immediately after leg amputation, the intracompartmental pressure in the deep posterior compartment was artificially raised to 100 mmHg with infused 0.9% sodium chloride solution. The resultant pressure changes in remaining compartments were recorded over 30 min. Five legs were evaluated. After 30 min, the mean maximum intracompartmental pressure increase found in the superficial posterior, anterior and peroneal compartments was 78.4 mmHg (range 65-94 mmHg), 25.2 mmHg (range 14-31 mmHg) and 24.8 mmHg (range 15-31 mmHg), respectively. This experimental data and case reports show that a compartment in which there is raised pressure may exert external pressure on a neighbouring compartment that can result in physiological changes to induce a compartment syndrome within that neighbour. The importance of assessing all compartments within a limb segment, even when associated with low velocity trauma, remains paramount.