AN EXPERIMENTAL STUDY INTO FOREARM COMPARTMENTAL PRESSURES

Abstract

Background: Chronic compartment syndrome is well recognised. Patients present with exercise-induced pain, relieved by rest. The condition is caused by increased intracompartmental pressure due to inadequate muscle compartment fascial size. Cases of forearm chronic compartment are sporadic. Previous published case series affecting the upper limb have not used compartment pressure monitoring to aid diagnosis. In our chronic compartment pressure monitoring clinic we confirmed the diagnosis of four cases. Following these a review of the literature showed that there was no definition of normal pre or post-exercise pressure for the upper limb.

Aim: This study aimed to establish the normal pre and post-exercise forearm pressures in asymptomatic normal individuals to give a baseline upon which perceived raised pressures could be calculated against.

Methods: Ethical approval was obtained from Dorset Research and Ethics Committee. 41 participants underwent compartment pressure measurements of the superficial extensor and flexor forearm compartments before and after five minutes of exercise. A Stryker intracom-partmental pressure monitor was used.

Results: Normal ranges for pre-exercise extensor compartment (2–27mmHg, upper CI 18.8–25.2mmHg), post-exercise extensor compartment (2–24mmHg, upper CI 16.8–22.8mmHg), pre-exercise flexor compartment (1–19mmHg, upper CI 13.3–17.4mmHg) and post-exercise flexor compartment (0–19mmHg, upper CI 16–21.4mmHg) pressures were established. No significant difference was found between pressures before and after exercise (extensor pressures; p=0.41, flexor pressures; p=0.21). There was a significant difference between sexes (extensor pressures; p=0.04, flexor pressures; p=0.008)

Conclusion: This study has shown a significant difference in normal forearm compartment pressures between sexes. No difference between pre and post-exercise pressure could be established. A normal reference range of forearm compartment pressures to aid diagnosis of chronic compartment syndrome has been determined. This may also prove useful in aiding the diagnosis of acute forearm compartment syndrome.