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Experimental study into forearm compartmental pressures
  1. A Ardolino,
  2. N Zeineh,
  3. D O'Connor
  1. Poole Hospital, Longfleet Road, Poole, Dorset

Abstract

Introduction Chronic compartment syndrome is well recognised, although rare in the forearm. In our chronic compartment syndrome clinic, we successfully identified and treated four cases. This prompted a literature review searching for normal ranges of forearm compartmental pressures. Existing normal forearm pressure ranges are based on lower limb measurements. This study aimed to establish normal pre- and postexercise forearm pressures.

Methods Using a Stryker intracompartmental pressure monitor, 41 participants underwent pressure measurements of the superficial extensor and flexor forearm compartments before and after exercise.

Results Normal ranges for pre-exercise extensor compartment (2–27 mm Hg, upper CI 18.8 to 25.2 mm Hg), postexercise extensor compartment (2–24 mm Hg, upper CI 16.8 to 22.8 mm Hg), pre-exercise flexor compartment (1–19 mm Hg, upper CI 13.3 to 17.4 mm Hg) and postexercise flexor compartment (0–19 mm Hg, upper CI 16–21.4 mm Hg) pressures were established. No significant pressure difference was found after exercise (extensor pressures; p=0.41, flexor pressures; p=0.21). There was no correlation between whether pressures increased or decreased following exercise. There was significant sex difference (extensor pressures; p=0.04, flexor pressures; p=0.008). Normal ranges for the extensor compartment were; 0–25.2 mm Hg and for the flexor compartment; 0–21.4 mm Hg.

Conclusions This study showed a significant difference in normal forearm compartment pressures between sexes. A normal reference range of forearm compartment pressures to aid diagnosis of chronic compartment syndrome has been determined. This may also prove useful in aiding diagnosis of acute forearm compartment syndrome.

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