Absolute compartment pressure versus differential pressure for the diagnosis of compartment syndrome in tibial fractures.

We studied 39 patients with 42 diaphyseal tibial fractures in whom we suspected a high risk for the development of a compartment syndrome. We measured the anterior absolute compartment pressure (ACP) every 12 h for 72 h and also recorded the differential pressure (DeltaP=diastolic blood pressure-ACP). Fasciotomy of the extremity was only performed when the differential pressure was less than 30 mmHg for more than 30 min. The highest values of the ACP were recorded between 24 h and 36 h after admission. Three fractures had a differential pressure less than 30 mmHg and all were treated by fasciotomy. In three fractures the ACP was equal to or higher than 50 mmHg, of which two had a differential pressure less than 30 mmHg. The patients were followed up for a mean of 36 months (29-45). All fractures healed, and none of our patients showed any sequelae of compartment syndrome at their last review.