Interobserver Variability in the Measurement of Lower Leg Compartment Pressures. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Large, Thomas M.; Agel, Julie; Holtzman, Daniel J.; Benirschke, Stephen K.; Krieg, James C.
• Is Part Of: Journal of orthopaedic trauma. Volume 29:Issue 7(2015)
• Publication Date: 2015-07
• Subjects: Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000000317
• Languages: English
• ISSNs: 0890-5339

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objectives:</title> <p>To determine whether interobserver technical variations and errors in the measurement of compartment pressures may affect measurement accuracy.</p> </sec> <sec> <title>Methods:</title> <p>Four above-knee cadaveric specimens were used to create a consistent model of lower leg compartment syndrome. Thirty-eight physicians examined the limbs and measured 4 compartment pressures using the Intra-Compartmental Pressure Monitor (Stryker Orthopaedics). They were observed for correct assembly and use of the monitor. Measurements obtained were compared with known pressures.</p> </sec> <sec> <title>Results:</title> <p>Of the total number of compartment measurements, 31% were made using the correct technique, 39% were made with lesser errors in technique, and 30% were made with catastrophic errors. Only 60% of measurements made with the correct technique were within 5 mm Hg of the standard pressure. Accuracy dropped to 42% for measurements taken with small errors in technique and 22% when a catastrophic error was committed.</p> </sec> <sec> <title>Conclusions:</title> <p>Variations in use of a commercially available pressure monitor exist, and errors are common. Proper use improved accuracy, but even with proper technique, 40% of the measurements were >5 mm Hg from the actual pressure. Based on our data, measurement accuracy with this device should be questioned and viewed within a range. Regular review and education of technique is strongly recommended.</p> </sec> </abstract>