COMPARTMENT PRESSURE MONITORING DURING INTRAMEDULLARY FIXATION OF TIBIAL FRACTURES

Twenty-six legs in 25 patients were monitored prospectively for compar tment pressures during intramedullary nailing of open and dosed tibial shaft fractures. Twenty-three patients were treated within 24 hours o f admission. Twenty-three unreamed and three reamed intramedullary rod s were utilized. Compartment pressures were measured initially, follow ing fracture reduction, and during reaming. Pressures were also measur ed at the completion of nailing with the ankle dorsiflexed and at rest (plantar flexed) to determine positional effects on compartment press ures. Nine fractures (35%) were found to have persistently elevated pr essures (>40 mm Hg) and underwent immediate four-compartment fasciotom y. The remaining group of 17 fractures (65%) was monitored throughout the intraoperative period. No patient monitored intraoperatively devel oped postoperative compartment syndrome.