Compartment syndrome, a devastating consequence
of limb trauma, is characterised by severe tissue injury and microvascular
perfusion deficits. We hypothesised that leucopenia might provide
significant protection against microvascular dysfunction and preserve
tissue viability. Using our clinically relevant rat model of compartment syndrome,
microvascular perfusion and tissue injury were directly visualised
by intravital video microscopy in leucopenic animals. We found that
while the tissue perfusion was similar in both groups (38.8% (standard
error of the mean (sem) 7.1), 36.4% (sem 5.7),
32.0% (sem 1.7), and 30.5% (sem 5.35) continuously-perfused
capillaries at 45, 90, 120 and 180 minutes compartment syndrome,
respectively versus 39.2% (sem 8.6), 43.5%
(sem 8.5), 36.6% (sem 1.4) and 50.8%
(sem 4.8) at 45, 90, 120 and 180 minutes compartment syndrome,
respectively in leucopenia), compartment syndrome-associated muscle
injury was significantly decreased in leucopenic animals (7.0% (sem 2.0), 7.0%,
(sem 1.0), 9.0% (sem 1.0) and 5.0% (sem 2.0)
at 45, 90, 120 and 180 minutes of compartment syndrome, respectively
in leucopenia group versus 18.0% (sem 4.0),
23.0% (sem 4.0), 32.0% (sem 7.0), and 20.0% (sem 5.0)
at 45, 90, 120 and 180 minutes of compartment syndrome in control,
p = 0.0005). This study demonstrates that the inflammatory process
should be considered central to the understanding of the pathogenesis
of cellular injury in compartment syndrome.
Cite this article: Bone Joint J 2015;97-B:539–43