Changes in tibial venous blood flow in the evolving compartment syndrome.

A sustained increase in muscle compartment pressures can cause tissue necrosis. When compartment pressures exceed recumbent tibial vein pressures, blood flow in tibial veins may be impaired. These changes can be detected by Doppler venous flow evaluation. In 26 patients at risk for compartment syndrome, serial examinations, Doppler venous flow, and measurements of compartment pressures were performed. All patients with abnormal Doppler venous flow results had or developed neuromuscular deficits. Patients with normal Doppler venous flow either initially or after fasciotomy did not develop the compartment syndrome. This syndrome can be evaluated and followed up sequentially by measuring Doppler venous flow in tibial veins.