Thomas M Large1, Julie Agel, Daniel J Holtzman, Stephen K Benirschke, James C Krieg. 1. *Orthopaedic Trauma Services, Mission Hospital, Asheville, NC; †Department of Orthopaedic Surgery and Sports Medicine, Harborview Medical Center, Seattle, WA; and ‡Rothman Institute at Thomas Jefferson University, Philadelphia, PA.
Abstract
OBJECTIVES: To determine whether interobserver technical variations and errors in the measurement of compartment pressures may affect measurement accuracy. METHODS: Four above-knee cadaveric specimens were used to create a consistent model of lower leg compartment syndrome. Thirty-eight physicians examined the limbs and measured 4 compartment pressures using the Intra-Compartmental Pressure Monitor (Stryker Orthopaedics). They were observed for correct assembly and use of the monitor. Measurements obtained were compared with known pressures. RESULTS: Of the total number of compartment measurements, 31% were made using the correct technique, 39% were made with lesser errors in technique, and 30% were made with catastrophic errors. Only 60% of measurements made with the correct technique were within 5 mm Hg of the standard pressure. Accuracy dropped to 42% for measurements taken with small errors in technique and 22% when a catastrophic error was committed. CONCLUSIONS: Variations in use of a commercially available pressure monitor exist, and errors are common. Proper use improved accuracy, but even with proper technique, 40% of the measurements were >5 mm Hg from the actual pressure. Based on our data, measurement accuracy with this device should be questioned and viewed within a range. Regular review and education of technique is strongly recommended.
OBJECTIVES: To determine whether interobserver technical variations and errors in the measurement of compartment pressures may affect measurement accuracy. METHODS: Four above-knee cadaveric specimens were used to create a consistent model of lower leg compartment syndrome. Thirty-eight physicians examined the limbs and measured 4 compartment pressures using the Intra-Compartmental Pressure Monitor (Stryker Orthopaedics). They were observed for correct assembly and use of the monitor. Measurements obtained were compared with known pressures. RESULTS: Of the total number of compartment measurements, 31% were made using the correct technique, 39% were made with lesser errors in technique, and 30% were made with catastrophic errors. Only 60% of measurements made with the correct technique were within 5 mm Hg of the standard pressure. Accuracy dropped to 42% for measurements taken with small errors in technique and 22% when a catastrophic error was committed. CONCLUSIONS: Variations in use of a commercially available pressure monitor exist, and errors are common. Proper use improved accuracy, but even with proper technique, 40% of the measurements were >5 mm Hg from the actual pressure. Based on our data, measurement accuracy with this device should be questioned and viewed within a range. Regular review and education of technique is strongly recommended.
Authors: Sanne Vogels; E D Ritchie; B L S Borger van der Burg; M R M Scheltinga; W O Zimmermann; R Hoencamp Journal: Sports Med Date: 2022-07-29 Impact factor: 11.928