The decision to perform a fasciotomy for a suspected closed compartment syndrome is frequently difficult. The signs and symptoms commonly used in establishing the diagnosis often cannot be adequately quantitated. In the past, fasciotomies frequently were undertaken after tissue injury was irreversible. More recently, the trend has been to do the procedure either empirically or with minimal evidence of ischemia in order to forestall tissue damage.
The principal factor present in the closed compartment syndrome is increased tissue pressure. The effectiveness of fasciotomy is based on relief of this pressure and reestablishment of tissue perfusion. The most logical means to improve our ability to deal with the syndrome would be direct measurement of the pressure within the closed compartment. We have devised a method that is simple, readily available, inexpensive, and reliable.
Studies involving dogs have shown that tissue injury increases as the duration of the ischemia increases.1