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Title: Acute compartment syndrome : its effect on bone blood flow and bone union
Author: McQueen, Margaret M.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1995
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Previous work on the acute compartment syndrome has concentrated on its effect on the soft tissues. A retrospective study demonstrated an increased likelihood of delayed union in tibial diaphyseal fractures complicated by acute compartment syndrome and its was suggested that this could be due to an effect on the bone blood flow. Bone blood flow using microspheres, bone union histologically and the strength of bone healing with biomechanical testing were examined in a series of New Zealand white rabbits after tibial osteotomy with or without an induced acute compartment syndrome. Six weeks after osteotomy bone blood flow is significantly elevated in the group with acute compartment syndrome while the tibial blood flow in the control group has returned to normal indicating a delay in the normal progression of the recovery of bone blood flow after osteotomy. This is reflected in the biomechanical testing which demonstrated significantly weaker bone union at six weeks in the compartment syndrome group. Histologically at this stage the callus in the experimental group is less mature than in the control groups. In the clinical study data was collected on 68 patients with acute compartment syndromes. Tibial diaphyseal fractures with clinical evidence of muscle necrosis took more than twice as long to unite as those without complications and delay to fasciotomy also caused a significant increase in union times. The clinical study also examined the use of compartment pressure monitoring and validated the use of a P measurement (diastolic pressure minus compartment pressure) of less than 30mm Hg as a threshold for decompression. Continuous compartment monitoring was shown to have a highly significant influence on the reduction of complications after acute compartment syndrome.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available