In suspected acute compartment syndrome of the leg, compartment pressure monitoring is indicated for fasciotomy when the intracompartmental pressure rises to within what distance of the patient's diastolic blood pressure?

• A Within 10 mmHg
• B Any value above 60 mmHg regardless of diastolic pressure
• C Within 50 mmHg
• D Within 30 mmHg ✓

Explanation

Fasciotomy is advised when compartment pressure is within 30 mmHg of diastolic blood pressure, or when the delta pressure, defined as diastolic minus compartment pressure, falls below 30 mmHg. This accounts for hypotensive patients who develop ischaemia at lower absolute pressures. An arbitrary absolute cutoff ignores perfusion pressure, and waiting for pressures near 50 or 60 mmHg risks irreversible muscle necrosis, which begins after roughly 6 to 8 hours of ischaemia.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

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Written and medically reviewed by the StethoPrep medical team.