EFFECTS OF HYPERBARIC-OXYGEN THERAPY ON PERFUSION PARAMETERS AND TRANSCUTANEOUS OXYGEN MEASUREMENTS IN PATIENTS WITH INTRAMEDULLARY NAILED TIBIAL SHAFT FRACTURES

We evaluated the effect of hyperbaric oxygen (HBO2) therapy on tibiali s posterior (TPA), dorsalis pedis (DPA), and sum(TPA+DPA) arterial pea k signals, as well as transcutaneous oxygen (Ptc(o2)) tension and leg skin temperature (T) after intramedullary nailing of tibial shaft frac tures. Twenty consecutive patients with closed and simple tibial shaft fractures treated with reamed intramedullary nailing were assigned ra ndomly to HBO2 or control groups. HBO2 therapy was given postoperative ly at 2.5 atm abs pressure for 90 min daily for a total of five treatm ents. The first HBO2 therapy was given 1 h after the operation. In bot h groups, measurements were performed preoperatively, 30 min and 6 h p ostoperatively, and on the following 5 days. There was a statistically significant improvement in TPA values in the nailed legs in the HBO2 treatment group after the first postoperative day, and these values re mained at a significantly higher level until the end of the study when compared to the nailed lees in the control group. Further, there was a statistically significant improvement in Ptc(o2) values in the naile d legs in the HBO2 group after the third HBO2 treatment. However, ther e were no statistically significant differences in DPA and TPA+DPA val ues within or between the nailed legs in HBO2 and control groups. HBO2 therapy seemed to decrease the skin temperature of the nailed legs, b ut this alteration was not statistically significant. In addition to t he clearly documented advantages in the management of crush injuries a nd compartment syndromes, HBO2 therapy has a positive effect on the pe rfusion parameter (TPA) and Ptc(o2) in patients with low energy, intra medullary nailed simple tibial shaft fractures. The improvement in TPA and Ptc(o2) values may result from the vasoconstrictive and edema red uctive effect on HBO2 with concomitant inhibition of inflammatory reac tions with slight cooling.