Success rates of lateral canthotomy and cantholysis for treatment of orbital compartment syndrome.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of Competing Interest None. 19. Injury. 2021 Apr;52(4):724-730. doi: 10.1016/j.injury.2020.10.069. Epub 2020 Oct 17. Non-invasive and reliable assessment of compartment elasticity by pressure related ultrasound: An in-vitro study. Sellei RM(1), Warkotsch U(2), Kobbe P(3), Weber CD(3), Reinhardt N(4), de la Fuente M(4), Radermacher K(4), Hildebrand F(3). Author information: (1)Department of Orthopaedic Trauma, Sana Hospital Offenbach, Offenbach am Main, Germany; Department of Orthopaedic Trauma and Reconstructive Surgery, University of Aachen Medical Center, Aachen, Germany. Electronic address: richard.sellei@sana.de. (2)Department of Vascular Surgery, Sana Hospital Offenbach, Offenbach am Main, Germany. (3)Department of Orthopaedic Trauma and Reconstructive Surgery, University of Aachen Medical Center, Aachen, Germany. (4)Medical Engineering, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany. PURPOSE: The development of acute compartment syndrome is a serious threat to trauma patients. The clinical assessment alone is not reliable enough to determine the need for fasciotomy in many cases. The Physician´s assessment of the elasticity of the muscle compartment might be particularly important to objectively evaluate the pressure in this enclosed space. The purpose of this study was to determine the observer´s reproducibility, of compartment elasticity measurements by a novel ultrasonic approach. METHODS: Increasing intra-compartmental pressures (ICP) were simulated in a water filled in-vitro model. Pressure related ultrasound was used to determine the relative elasticity (RE) of soft tissue compartments. A pressure transducing probe head was combined with the ultrasonic probe to obtain cross section views of the simulated compartment and to detect the amount of applied pressure by the observer. In this model, the compartment depth without compression (P0) was set to be 100%. Changes of the compartment depth due to a probe pressure of 80 mmHg (P80) were correlated to P0 and an elasticity quotient as a value for RE (%) was calculated. Twelve blinded observers performed measurements for RE determination (%) under three pressure conditions. Reproducibility was calculated using intraclass correlation coefficient (ICC). RESULTS: Measurements (n = 432) revealed that the RE (%) in the control group was 17,06% (SD+/-2,13), whereas the RE of the group ICP30 significantly decreased to 12,66% (SD+/- 1,19) (p