REAMED TIBIAL INTERLOCK NAILING;

PREOPERATIVE AND POSTOPERATIVE COMPARTMENT PRESSURE MEASUREMENT

Abstract

Objective: The objective is to measure preoperative and postoperative compartment pressure in reamed tibial interlock nailing
using Whitesides infusion technique. Duration: This study is carried out from September 2007 to August 2008 Setting: Department of
Orthopedic and Spine Surgery of Hayatabad Medical Complex Peshawar Material and Methods: Thirty consecutive patients that were
candidates for closed reamed interlock nailing of the tibia and there compartment pressure were measured preoperatively and postoperatively
by Whiteside infusion technique. Results: Average age of patient was 35 years. Male were 26(86.66%) and female were 4(13.34%). There
were 12(40%) type A and 18(60%) type B fractures according to Orthopedic Trauma Association (OTA) AO classification. Twenty seven (90%)
factures were due to motor vehicle accident and 3(10%) were due to fall. The minimum preoperative pressure in superficial posterior
compartment was 7 millimeter of mercury (mm Hg), deep posterior compartment was 10 mm Hg, anterior compartment was 10 mm Hg, lateral
compartment was 10 mm Hg while maximum pressure in was 25, 25, 25 and 25 mm Hg respectively. The maximum post operative pressure in
superficial posterior compartment was 10 mm Hg minimum and 25 mm Hg maximum, deep posterior compartment was 15 and 28 , anterior
compartment was 15 and 30 and in lateral compartment was 10 mm Hg minimum and 30 mm Hg maximum. The minimum diastolic blood
pressure was 65 and maximum was 90 mm Hg. Conclusions: Compartment pressure measurement by Whitesides’ infusion technique is a
simple and effective method for monitoring the intracompartmental pressure. It avoids unnecessary fasciotomy that has an extra morbidity in
terms of infection and skin coverage.