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Sellei RM, Hingmann SJ, Kobbe P, et al. Compartment elasticity measured by pressure-related ultrasound to determine patients "at risk" for compartment syndrome: an experimental in vitro study. Patient Saf Surg. 2015;9(1):4doi: 10.1186/s13037-014-0051-4.
Sellei, R. M., Hingmann, S. J., Kobbe, P., Weber, C., Grice, J. E., Zimmerman, F., Jeromin, S., Hildebrand, F., & Pape, H. C. (2015). Compartment elasticity measured by pressure-related ultrasound to determine patients "at risk" for compartment syndrome: an experimental in vitro study. Patient safety in surgery, 9(1), 4. https://doi.org/10.1186/s13037-014-0051-4
Sellei, Richard Martin, et al. "Compartment elasticity measured by pressure-related ultrasound to determine patients "at risk" for compartment syndrome: an experimental in vitro study." Patient safety in surgery vol. 9,1 (2015): 4. doi: https://doi.org/10.1186/s13037-014-0051-4
Sellei RM, Hingmann SJ, Kobbe P, Weber C, Grice JE, Zimmerman F, Jeromin S, Hildebrand F, Pape HC. Compartment elasticity measured by pressure-related ultrasound to determine patients "at risk" for compartment syndrome: an experimental in vitro study. Patient Saf Surg. 2015 Jan 24;9(1):4. doi: 10.1186/s13037-014-0051-4. eCollection 2015. PMID: 25621009; PMCID: PMC4305259.
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Patient Saf Surg. 2015 Jan 24;9(1):4. doi: 10.1186/s13037-014-0051-4. eCollection 2015.

Compartment elasticity measured by pressure-related ultrasound to determine patients "at risk" for compartment syndrome: an experimental in vitro study.

Patient safety in surgery

Richard Martin Sellei, Simon Johannes Hingmann, Philipp Kobbe, Christian Weber, John Edward Grice, Frauke Zimmerman, Sabine Jeromin, Frank Hildebrand, Hans-Christoph Pape

Affiliations

  1. Department of Orthopaedic Trauma, Aachen University Medical Center, Aachen, Germany ; Department of Orthopaedic Trauma, Sana Klinikum Offenbach am Main, Offenbach am Main, Germany.
  2. Department of Orthopaedic Trauma, Aachen University Medical Center, Aachen, Germany.
  3. Department of Orthopaedics and Trauma, Queen Alexandra Hospital, Portsmouth, UK.
  4. Helmholtz-Institute for biomedical engineering, Chair of medical engineering, RWTH Aachen University, Aachen, Germany.

PMID: 25621009 PMCID: PMC4305259 DOI: 10.1186/s13037-014-0051-4

Abstract

BACKGROUND: Decision-making in treatment of an acute compartment syndrome is based on clinical assessment, supported by invasive monitoring. Thus, evolving compartment syndrome may require repeated pressure measurements. In suspected cases of potential compartment syndromes clinical assessment alone seems to be unreliable. The objective of this study was to investigate the feasibility of a non-invasive application estimating whole compartmental elasticity by ultrasound, which may improve accuracy of diagnostics.

METHODS: In an in vitro model, using an artificial container simulating dimensions of the human anterior tibial compartment, intra-compartmental pressures (p) were raised subsequently up to 80 mmHg by infusion of saline solution. The compartmental depth (mm) in the cross-section view was measured before and after manual probe compression (100 mmHg) upon the surface resulting in a linear compartmental displacement (∆d). This was repeated at rising compartmental pressures. The resulting displacements were related to the corresponding intra-compartmental pressures simulated in our model. A hypothesized relationship between pressures related compartmental displacement and the elasticity at elevated compartment pressures was investigated.

RESULTS: With rising compartmental pressures, a non-linear, reciprocal proportional relation between the displacement (mm) and the intra-compartmental pressure (mmHg) occurred. The Pearson coefficient showed a high correlation (r(2) = -0.960). The intra-observer reliability value kappa resulted in a statistically high reliability (κ = 0.840). The inter-observer value indicated a fair reliability (κ = 0.640).

CONCLUSIONS: Our model reveals that a strong correlation between compartmental strain displacements assessed by ultrasound and the intra-compartmental pressure changes occurs. Further studies are required to prove whether this assessment is transferable to human muscle tissue. Determining the complete compartmental elasticity by ultrasound enhancement, this application may improve detection of early signs of potential compartment syndrome.

Keywords: Compartment syndrome; Elasticity measurement; Elastography; Intra-compartmental pressure; Non-invasive diagnostic

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