Following a tibial plateau fracture treated with ORIF, a patient develops acute compartment syndrome. The threshold for fasciotomy based on absolute compartment pressure is:

• A >10 mmHg
• B >30 mmHg OR within 30 mmHg of diastolic blood pressure (delta-P <30 mmHg) ✓
• C >20 mmHg
• D >50 mmHg

Explanation

Fasciotomy is indicated when the absolute compartment pressure exceeds 30 mmHg, OR — more importantly in hypotensive patients — when the delta-P (diastolic BP minus compartment pressure) is <30 mmHg (Matsen's criterion). The delta-P threshold accounts for perfusion pressure and is a better indicator of ischaemia risk than absolute pressure alone. Waiting for pressure >50 mmHg risks irreversible ischaemic injury; a threshold of >30 mmHg or delta-P <30 mmHg is the widely accepted guideline from Whitesides, McQueen, and Court-Brown.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.