Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, P. R. China.
Department of Pharmacy, The Second Hospital of Hebei Medical University, Shijiazhuang, P. R. China.
PLoS One. 2024 Oct 29;19(10):e0312526. doi: 10.1371/journal.pone.0312526. eCollection 2024.
Acute compartment syndrome (ACS) is a serious medical condition that can be encountered in tibial plateau fractures. However, no studies of compartment pressure changes in patients with tibial plateau fractures compared to patient without fractures have been reported. To obtain a comprehensive understanding of the pressure changes in patients with fractures, we monitored and recorded the compartment pressure and attempted to reveal the potential pressure release function of the human fascia.
Cohorts of 43 normal individuals and 23 patients (initial 33, 10 were excluded due to inclusion criteria) and include the number of patients who completed the study with closed tibial fractures (the fracture group, FG, which comprised 6 men and 17 women) were included in this retrospective research. Compartment pressures were measured with Icare, a device that is traditionally used to measure intraocular pressure. Results of measurements at 6 different locations in the lower limb were recorded and compared for three days (days 2, 3, and 4 post fracture) between normal cohort (CG) and fracture cohort (FG) patients.
The compartment pressures were comparable at each pressure measurement site (upper, middle and lower) in patients of the CG and the FG. Compared with the CG patients, there was a significant increase in compartment pressure at the upper lateral location in 18-45-year-old patients in the FG (P = 0.013) and at the upper lateral (P = 0.004) and medial locations (P = 0.005) in 46-69-year-old patients, and the values tended to normalize over time. Compared with the contralateral normal limb of patients in the FG, there was a significant increase in compartment pressure at the upper lateral location in 18-45-year-old patients (P = 0.009) and at the upper lateral (P = 0.015) and medial locations (P = 0.016) in 46-69-year-old patients on the fractured side. Based on different fracture classifications, there were no significant differences in compartment pressure at the medial (upper, middle and lower) locations when compared with pressures at the corresponding lateral sites of measurement.
The results of this study revealed that the fascial compartment as a whole can release the increased intracompartment pressure after fracture to prevent complications such as acute compartment syndrome caused by a continued increase in pressure. The Icare as a portable device, is potentially useful in compartmental pressure measurement especially in emergency room.
急性骨筋膜室综合征（ACS）是一种严重的医学病症，可能发生在胫骨平台骨折中。然而，目前尚无研究比较胫骨平台骨折患者与无骨折患者的筋膜室压力变化。为了全面了解骨折患者的压力变化，我们监测并记录了筋膜室压力，并试图揭示人体筋膜的潜在压力释放功能。
本回顾性研究纳入了 43 名正常个体和 23 名患者（最初为 33 名，因纳入标准有 10 名被排除），包括完成闭合性胫骨骨折研究的患者人数（骨折组，FG，其中包括 6 名男性和 17 名女性）。使用传统上用于测量眼内压的 Icare 设备测量下肢 6 个不同部位的筋膜室压力。记录并比较了正常组（CG）和骨折组（FG）患者骨折后第 2、3 和 4 天的测量结果。
CG 和 FG 患者各压力测量部位（上、中、下）的筋膜室压力相当。与 CG 患者相比，FG 中 18-45 岁患者的外侧上部位筋膜室压力显著升高（P = 0.013），46-69 岁患者的外侧上（P = 0.004）和内侧部位（P = 0.005）筋膜室压力也显著升高，且这些压力值随时间趋于正常化。与 FG 患者骨折侧的对侧正常肢体相比，18-45 岁患者的外侧上部位（P = 0.009）和 46-69 岁患者的外侧上（P = 0.015）和内侧部位（P = 0.016）筋膜室压力显著升高。根据不同的骨折分类，内侧（上、中、下）部位的筋膜室压力与相应外侧测量部位的压力相比没有显著差异。
本研究结果表明，整个筋膜室作为一个整体，可以在骨折后释放增加的筋膜室压力，以防止因压力持续增加而引起的急性骨筋膜室综合征等并发症。Icare 作为一种便携式设备，在特别是在急诊室的筋膜室压力测量中具有潜在的应用价值。
