Non-invasive measurement of muscle compartment elasticity in lower limbs to determine acute compartment syndrome: Clinical results with pressure related ultrasound

• Published in: Injury 2020-02, Vol.51 (2), p.301-306
• Main Authors: Sellei, R.M., Wollnitz, J., Reinhardt, N., de la Fuente, M., Radermacher, K., Weber, C., Kobbe, P., Hildebrand, F.
• Format: Article
• Language: English
• Subjects: Acute compartment syndrome; Muscle compartment elasticity; Non-invasive measurement; Pressure related ultrasound
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2019.11.027

•Novel method of non-invasive measurement of muscle elasticity.•Reliable approach for monitoring imminent acute compartment syndrome.•High correlation between the decreasing elasticity and increasing intra-compartmental pressure. Close monitoring of patients at risk to develop an acute compartment syndrome (ACS) is well known to be essential. There is a relevant risk that clinical assessment alone is not reliable enough. Reliable assessment of the elasticity of the muscle compartment might represent a helpful tool to assess the pressure in this enclosed space. Therefore, the purpose of this study was to determine the feasibility of muscle elasticity measurements by a non-invasive device. In a prospective study, patients with elevated intra-compartmental pressure (ICP) were included. An ultrasound-based measurement approach was used to determine the relative elasticity (RE) of both, the affected and unaffected limb. A pressure transducing ultrasonic probe head was combined with the probe to obtain cross section views of the anterior tibial compartment and to detect the observer´s amount of pressure applied on the limb surface. The compartment depth without compression (P0) corresponds to 100%. The difference to the compartment depth with a probe pressure of 80mmHg (P80) on the limb (delta) related to P0 resulted in a value of relative elasticity (%). These values were compared with the invasive needle measurement (mmHg) regarding their intra-individual difference and correlation of the compartmental pressure. In six trauma patients the relative elasticity in their paired limbs showed a significant difference. The RE in the healthy compartments revealed a level of 17.95% (SD+/-5,4), whereas the RE of the affected limbs significantly decreased to a mean of 5,14% (SD+/-2,1) (p