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ANTERIOR TIBIAL COMPARTMENT PRESSURES IN SPINAL CORD INJURED PATIENTS

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Compartment Syndrome is a dreaded complication associated witha poor outcome if unrecognised in neurologically intact patients. This is also true in those with a spinal cord injury, but it is unclear from the current literature if this unique cohort of patients has different baseline vlaues for diastolic blood, compartment and perfusion pressures.

This study was designed to test the Null Hypothesis that there is no difference between the values of these variables in intact “normal” patients and those with a spinal cord injury; in addition, comparisons were made between different ASIA groups and anatomical level of injury. The results revealed significant differences between complete (ASIA A) injuries and normal patients in diastoic blood and perfusion pressures (p=0.005, and 0.003 respectively). There was also a difference between complete and normal compartment pressure (p=0.009). Differences were found in cervical and thoracic diastolic blood pressures when compared to normal (p=0.07 and 0.09 resepectively), and between thoracic and lumbar diastolic pressures(p=0.06).

In summary, those with spinal cord injuries tended to have lowered diastolic and perfusion pressures, and higher compartment pressures. These results demonstrate the importance of close surveillance of spinally injured patients with concomitant limb trauma. We would recommend routine compartment pressure monitoring in all such cases, especially as they are also relatively hypotensive and will not tolerate elevation of compartment pressure well.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.