EFFECTIVENESS OF THE LOCALLY MADE TOOL TO CONFIRM ACUTE COMPARTMENT SYNDROME BY WHITESIDES INFUSION TECHNIQUE

Mohammad Suman Sutar*, Obaidur Rahman, Md. Yakub Ali and Md. Ehteshamul Choudhury

ABSTRACT

Acute limb compartment syndrome is an Orthopaedics emergency which demands accurate diagnosis and prompt management to save the limb and sometimes life. To avoid a missed diagnosis or an unnecessary fasciotomy, direct measurement of compartment pressure is required. The device, assembled locally with simple and easily available cheap tools, to measure the intracompartmental pressure in legs by Whitesides infusion technique, was found safe and effective. Aim of this study was to assess the effectiveness of the device for intracompartmental pressure measurement to confirm the clinically diagnosed compartment syndrome. This prospective observational study was conducted in NITOR on 50 patients enrolled by inclusion and exclusion criteria. Suspected cases underwent clinical and radiological evaluation. Blood pressure and anterior leg compartment pressure were measured. Delta pressure calculated and value less than 30 mmHg confirmed the clinical diagnosis. Determinant clinical findings were pain on passive stretching (86%) and blisters (44%). 43 (86%) cases were diagnosed to have acute compartment syndrome on clinical ground whereas in 40 (80%) cases the Delta pressure of less than 30 mmHg confirmed the diagnosis. No statistical difference was found between the two processes in the diagnosis of acute compartment syndrome in leg (p = 0.616). The study showed that 70% of the cases were positively diagnosed by both clinically and the device. It was thus concluded that the locally made device was effective in measurement of compartment pressure by Whitesides infusion technique.

Keywords: Acute Compartment Syndrome, Locally assembled tool, Whitesides Infusion Technique, Intracompartmental pressure, Delta pressure.