Factors affecting forearm compartment pressures in children with supracondylar fractures of the humerus

J Pediatr Orthop. 2002 Jul-Aug;22(4):431-9.

Abstract

This study evaluated forearm compartment pressures in 29 children with supracondylar humerus fractures. Pressures were measured before and after reduction in the dorsal, superficial volar, and deep volar compartments at the proximal 1/6th and proximal 1/3rd forearm. Pressures in the deep volar compartment were significantly elevated compared with pressures in other compartments. There were also significantly higher pressures closer to the elbow within each compartment. Fracture reduction did not have a consistent immediate effect on pressures. The effect of elbow flexion on post-reduction pressures was also evaluated; flexion beyond 90 degrees produced significant pressure elevation. We conclude that forearm pressures after supracondylar fracture are greatest in the deep volar compartment and closer to the fracture site. Pressures greater than 30 mm Hg may exist without clinical evidence of compartment syndrome. To avoid unnecessary elevation of pressures, elbows should not be immobilized in >90 degrees of flexion after these injuries.

MeSH terms

  • Adolescent
  • Analysis of Variance
  • Child
  • Child, Preschool
  • Compartment Syndromes / diagnosis*
  • Compartment Syndromes / epidemiology
  • Compartment Syndromes / etiology
  • Elbow Injuries
  • Female
  • Forearm
  • Fracture Fixation / adverse effects
  • Fracture Fixation / methods*
  • Fracture Healing / physiology
  • Humans
  • Humeral Fractures / surgery*
  • Humeral Fractures / therapy
  • Incidence
  • Male
  • Pressure
  • Probability
  • Prospective Studies
  • Range of Motion, Articular / physiology
  • Recovery of Function
  • Risk Factors
  • Sampling Studies