Abstract
Background: Chronic compartment syndrome is well recognised. Patients present with exercise-induced pain, relieved by rest. The condition is caused by increased intra-compartmental pressure due to inadequate muscle/fascial compartment size. Cases of forearm chronic compartment syndrome 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 diagnoses a review of the literature showed that there was no definition of normal pre or post exercise pressure for the upper limb.
Aim: Acknowledging that diagnosis of forearm chronic compartment syndrome is largely based on clinical presentation supported by an ever increasing use of hand-held compartment pressure monitors, we felt it was important to establish what represented the normal pre and post exercise pressures in asymptomatic normal individuals to give a baseline upon which perceived raised pressures can be calculated against.
Methods: Ethical approval was obtained from Dorset Research and Ethics Committee. 41 participants underwent compartment pressure measurements of the superficial flexor and extensor compartments of the forearm before and five minutes following exercise. A Stryker intracompartmental pressuremonitor was used.
Results: Normal ranges for pre-exercise extensor compartment (2–27mmHg, CI 18.8–25.2mmHg), post-exercise extensor compartment (2–24mmHg, CI16.8–22.8mmHg), pre-exercise flexor compartment (1–19mHg, CI 13.3–17.4mmHg)) and post-exercise flexor compartment (0–19mmHg, CI 16–21.4) 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)
Discussion: This study has established a significant difference in normal forearm compartment pressures between sexes. A normal reference range of forearm compartment pressures to aid diagnosis of chronic compartment syndrome has been determined. This can also be useful in diagnosing acute compartment syndrome.
The abstracts were prepared by Mr Matt Costa and Mr Ben Ollivere. Correspondence should be addressed to Mr Costa at Clinical Sciences Research Institute, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, UK.
