Non-invasive assessment of muscle compartment elasticity by pressure-related ultrasound in pediatric trauma: a prospective clinical study in 25 cases of forearm shaft fractures.
Acute compartment syndrome
Muscle compartment
Non-invasive
Pressure-related ultrasound
Relative elasticity
Journal
European journal of medical research
ISSN: 2047-783X
Titre abrégé: Eur J Med Res
Pays: England
ID NLM: 9517857
Informations de publication
Date de publication:
25 Aug 2023
25 Aug 2023
Historique:
received:
26
05
2022
accepted:
15
07
2023
medline:
28
8
2023
pubmed:
26
8
2023
entrez:
25
8
2023
Statut:
epublish
Résumé
Soft-tissue swelling after limb fractures in pediatric patients is well known to be a risk factor for developing acute compartment syndrome (ACS). Clinical assessment alone is uncertain in specific cases. Recently, we proposed a non-invasive ultrasound-based method to objectify muscle compartment elasticity for monitoring. We hypothesize a strong correlation between the soft-tissue swelling after stabilization of upper limb fractures and the compartment elasticity objectified with a novel ultrasound-based approach in pediatric trauma. In a prospective clinical study, children suffering forearm fractures but not developing an ACS were included. The muscle compartment elasticity of the m. flexor carpi ulnaris was assessed after surgical intervention by a non-invasive, ultrasound-based method resulting in a relative elasticity (RE in %) in both the control (healthy limb) and study group (fractured limb). Soft-tissue swelling was categorized in four different levels (0-3) and correlated with the resulting RE (%). The RE in the study group (15.67%, SD ± 3.06) showed a significantly decreased level (p < 0.001) compared with the control (22.77%, SD ± 5.4). The categorized grade of soft-tissue swelling resulted in a moderate correlation with the RE (r The presented study appears to represent a novel approach to assess the posttraumatic pressure changes in a muscle compartment after fracture stabilization non-invasively. In this first clinical study in pediatric cases, our measurement method represents a low-cost, easy, and secure approach that has the potential to substitute invasive measurement of suspected ACS in muscle compartment conditions. Further investigations in lager cohorts are required to prove its daily clinical practicability and to confirm the expected reliability.
Sections du résumé
BACKGROUND
BACKGROUND
Soft-tissue swelling after limb fractures in pediatric patients is well known to be a risk factor for developing acute compartment syndrome (ACS). Clinical assessment alone is uncertain in specific cases. Recently, we proposed a non-invasive ultrasound-based method to objectify muscle compartment elasticity for monitoring. We hypothesize a strong correlation between the soft-tissue swelling after stabilization of upper limb fractures and the compartment elasticity objectified with a novel ultrasound-based approach in pediatric trauma.
PATIENTS AND METHODS
METHODS
In a prospective clinical study, children suffering forearm fractures but not developing an ACS were included. The muscle compartment elasticity of the m. flexor carpi ulnaris was assessed after surgical intervention by a non-invasive, ultrasound-based method resulting in a relative elasticity (RE in %) in both the control (healthy limb) and study group (fractured limb). Soft-tissue swelling was categorized in four different levels (0-3) and correlated with the resulting RE (%).
RESULTS
RESULTS
The RE in the study group (15.67%, SD ± 3.06) showed a significantly decreased level (p < 0.001) compared with the control (22.77%, SD ± 5.4). The categorized grade of soft-tissue swelling resulted in a moderate correlation with the RE (r
CONCLUSIONS
CONCLUSIONS
The presented study appears to represent a novel approach to assess the posttraumatic pressure changes in a muscle compartment after fracture stabilization non-invasively. In this first clinical study in pediatric cases, our measurement method represents a low-cost, easy, and secure approach that has the potential to substitute invasive measurement of suspected ACS in muscle compartment conditions. Further investigations in lager cohorts are required to prove its daily clinical practicability and to confirm the expected reliability.
Identifiants
pubmed: 37626380
doi: 10.1186/s40001-023-01232-1
pii: 10.1186/s40001-023-01232-1
pmc: PMC10463760
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
296Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
J Orthop Trauma. 2002 Sep;16(8):572-7
pubmed: 12352566
J Trauma Acute Care Surg. 2019 Jul;87(1S Suppl 1):S59-S66
pubmed: 31246908
Injury. 2020 Feb;51(2):301-306
pubmed: 31784057
Eur J Orthop Surg Traumatol. 2020 Jul;30(5):839-844
pubmed: 32107640
Patient Saf Surg. 2015 Jan 24;9(1):4
pubmed: 25621009
J Orthop Trauma. 2007 Nov-Dec;21(10 Suppl):S135-60
pubmed: 18277238
J Orthop Trauma. 2015 Jul;29(7):316-21
pubmed: 25756911
Emerg Med Clin North Am. 2000 Feb;18(1):115-39, vi
pubmed: 10678162
Chirurgie (Heidelb). 2023 Jan;94(1):93-102
pubmed: 35352147
Injury. 2021 Apr;52(4):724-730
pubmed: 33902865
J Bone Joint Surg Am. 1980 Mar;62(2):286-91
pubmed: 7358759
Medicine (Baltimore). 2020 Jun 05;99(23):e20504
pubmed: 32501996
Eur J Trauma Emerg Surg. 2015 Dec;41(6):639-45
pubmed: 26037985
Unfallchirurg. 2014 Jul;117(7):633-49
pubmed: 25030961
Front Bioeng Biotechnol. 2022 Jul 18;10:801586
pubmed: 35923576
J Child Orthop. 2016 Oct;10(5):453-60
pubmed: 27538943
J Orthop Trauma. 2023 Aug 1;37(8):e319-e325
pubmed: 37053115
Int Orthop. 2019 Nov;43(11):2429-2435
pubmed: 31468110
J Bone Joint Surg Br. 1996 Jan;78(1):99-104
pubmed: 8898137
Injury. 2022 Feb;53(2):719-723
pubmed: 34963511