Zhang Heng, Li Luqi, Jia Huiyang, Wang Haofei, Dong Qi, Guo Jialiang, Hou Zhiyong
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China.
Engineering Research Center of Orthopedic Minimally Invasive Intelligent Equipment, Ministry of Education, Shijiazhuang, 050051, Hebei, China.
J Orthop Surg Res. 2025 Aug 30;20(1):807. doi: 10.1186/s13018-025-06241-w.
This study aimed to investigate the utility of shear wave elastography (SWE) as a noninvasive diagnostic tool for assessing anterior compartment intracompartmental pressure (ICP) in patients with tibial plateau fractures, facilitating early detection of high compartment pressure (HCP) to mitigate acute compartment syndrome (ACS) risks.
In this cross-sectional study conducted from January 2024 to March 2025 at a tertiary hospital in China, 170 patients aged 18-65 years with tibial plateau fractures diagnosed within 48 h were enrolled. Demographic data, injury mechanisms, Schatzker classification, and laboratory parameters were collected. shear wave velocity (SWV) was measured via SWE on both injured and contralateral anterior compartment muscles, alongside invasive ICP monitoring. Statistical analyses encompassed Spearman's correlations, stepwise logistic regression for a multivariate model incorporating SWV, age, and fracture type, and receiver operating characteristic (ROC) curves for diagnostic performance.
Among participants (57.1% male, median age 45 years), 44 exhibited HCP (ICP ≥ 30 mmHg). Injury-side SWV and SWV differential showed strong positive correlations with ICP (ρ = 0.704 and 0.535, respectively; both P < 0.001). Significant SWV disparities were observed between HCP and non-HCP groups (P < 0.001). The multivariate model yielded an AUC of 0.880, with 93.2% sensitivity and 71.4% specificity, demonstrating consistent performance across gender subgroups. Adjusted odds ratios highlighted injury-side SWV (aOR 5.99) and Schatzker Ⅳ-Ⅵ fractures (aOR 4.14) as key predictors.
Our study results indicate that SWE can reliably and noninvasively detect HCP in tibial plateau fractures, providing superior diagnostic accuracy and clinical applicability.
本研究旨在探讨剪切波弹性成像（SWE）作为一种非侵入性诊断工具，用于评估胫骨平台骨折患者前侧骨筋膜室内压力（ICP）的效用，以便早期发现高骨筋膜室压力（HCP），降低急性骨筋膜室综合征（ACS）风险。
在中国一家三级医院于2024年1月至2025年3月进行的这项横断面研究中，纳入了170例年龄在18至65岁之间、在48小时内被诊断为胫骨平台骨折的患者。收集了人口统计学数据、损伤机制、Schatzker分类和实验室参数。通过SWE测量受伤侧和对侧前侧骨筋膜室肌肉的剪切波速度（SWV），同时进行有创ICP监测。统计分析包括Spearman相关性分析、纳入SWV、年龄和骨折类型的多变量模型的逐步逻辑回归分析，以及诊断性能的受试者操作特征（ROC）曲线分析。
在参与者中（57.1%为男性，中位年龄45岁），44例出现HCP（ICP≥30 mmHg）。受伤侧SWV和SWV差值与ICP呈强正相关（分别为ρ = 0.704和0.535；均P < 0.001）。HCP组和非HCP组之间观察到显著的SWV差异（P < 0.001）。多变量模型的AUC为0.880，灵敏度为93.2%，特异度为71.4%，在不同性别亚组中表现一致。调整后的优势比突出了受伤侧SWV（aOR 5.99）和SchatzkerⅣ-Ⅵ型骨折（aOR 4.14）作为关键预测因素。
我们的研究结果表明，SWE能够可靠且非侵入性地检测胫骨平台骨折中的HCP，具有卓越的诊断准确性和临床适用性。
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