Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT, USA.
Department of Pathology, University of Utah, Salt Lake City, UT, USA.
J Orthop Surg Res. 2024 Oct 4;19(1):622. doi: 10.1186/s13018-024-05131-x.
Most existing animal models of acute compartment syndrome (ACS) rely on exogenous manipulation of intra-compartmental pressures to model ACS. The purpose of the current study was to evaluate the endogenous effect of a blast injury on porcine lower leg intra-compartmental pressures (ICP).
The hindlimb of juvenile Landrace pigs was fractured at the diaphyseal tibia and subjected to blasts of compressed air to mimic a blast injury. Injured and control legs underwent pre-operative continuous ICP monitoring. At 4.5 h post injury, the fracture was stabilized followed by closure of the anterior compartment fascia (continued compartment pressure model, CCPM) or four compartment fasciotomy. Pressure measurements were made after operative fixation. Select pigs in CCPM were harvested between 48 and 72 h post-injury to evaluate the duration of ICP elevation.
Post-injury, the model created significantly elevated ICP compared to control limbs (54.5 ± 18.2 vs. 18.2 ± 4.9 mmHg; p < 0.001). Operative fixation and anterior compartment fascial closure further increased the ICP (Mean: 87.4 ± 42.5 mmHg) relative to the pre-operative state (p = 0.037). Fasciotomy returned baseline compartment pressures (Mean: 13.7 ± 10.2 mmHg) which were equivalent to control limbs (p = 0.117). Pressure measurements at the time of delayed harvest (48-72 h) demonstrated that elevated ICP persisted following injury (69.7 ± 55.12 mmHg).
The current study demonstrates that a pilot porcine blast model elevates ICP comparable to existing animal models of compartment syndrome without exogenous ICP manipulation. ICP remained elevated at 48-72 h in the absence of fasciotomy.
大多数现有的急性间隔综合征（ACS）动物模型依赖于对内间隔压力的外源性操作来模拟 ACS。本研究的目的是评估爆炸伤对猪小腿内间隔压力（ICP）的内源性影响。
幼年长白猪的后肢在骨干胫骨处骨折，并接受压缩空气爆炸以模拟爆炸伤。受伤和对照腿在术前进行连续 ICP 监测。在受伤后 4.5 小时，骨折被稳定，然后关闭前间隔筋膜（持续间隔压力模型，CCPM）或四个间隔筋膜切开术。在手术固定后进行压力测量。在 CCPM 中选择一些猪在受伤后 48 至 72 小时收获，以评估 ICP 升高的持续时间。
受伤后，模型与对照肢体相比，ICP 显著升高（54.5 ± 18.2 对 18.2 ± 4.9 mmHg；p < 0.001）。手术固定和前间隔筋膜闭合进一步增加了 ICP（平均值：87.4 ± 42.5 mmHg），与术前状态相比（p = 0.037）。筋膜切开术使间隔压力恢复基线（平均值：13.7 ± 10.2 mmHg），与对照肢体相同（p = 0.117）。在延迟收获时（48-72 小时）的压力测量表明，受伤后 ICP 持续升高（69.7 ± 55.12 mmHg）。
本研究表明，一种初步的猪爆炸模型在不进行外源性 ICP 操作的情况下，可使 ICP 升高到与现有的间隔综合征动物模型相当的水平。在没有筋膜切开术的情况下，48-72 小时时 ICP 仍处于升高状态。
