Logo image
Back
Accuracy of measurement of hand compartment pressures: a cadaveric study
Journal article   Peer reviewed

Accuracy of measurement of hand compartment pressures: a cadaveric study

Justin C Wong, Michael M Vosbikian, Joseph M Dwyer and Asif M Ilyas
The Journal of hand surgery (American ed.), v 40(4), pp 701-706
01 Apr 2015
DOI: https://doi.org/10.1016/j.jhsa.2014.12.003
PMID: 25648783
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Cadaver Compartment Syndromes - diagnosis Compartment Syndromes - physiopathology Hand Humans Manometry Palpation Sensitivity and Specificity
To determine the accuracy of digital palpation for clinical assessment of elevated intracompartmental pressure compared with needle manometry in a simulated compartment syndrome of the hand. Three cadaveric hands were configured with interstitial fluid infusion and an arterial line pressure monitor to create and continuously measure intracompartmental pressure in the thenar and hypothenar compartments. Seventeen assessors clinically judged the presence or absence of compartment syndrome based on digital palpation for firmness and then measured pressures with a handheld manometer. An intracompartmental pressure threshold of 30 mm Hg or greater was used to diagnose compartment syndrome. The sensitivity and specificity of digital palpation of the thenar eminence were 49% and 79%, respectively, with a positive predictive value (PPV) of 86% and negative predictive value (NPV) of 37%. Using the handheld manometer, the sensitivity and specificity increased to 97% and 86% with a PPV of 95% and NPV of 92%. The sensitivity and specificity of digital palpation of the hypothenar eminence were 62% and 83%, respectively, with improvement of 100% and 100%, respectively, with a handheld manometer. For the hypothenar compartment, use of a handheld manometer improved the PPV from 92% to 100% and the NPV from 40% to 100% compared with digital palpation. Digital palpation alone was insufficient to detect elevated compartment pressures in hands at risk for compartment syndrome. Handheld invasive pressure measurement was a useful adjunct for detecting elevated interstitial tissue pressures and may aid in diagnosing compartment syndrome. Diagnostic II.

Metrics

7 Record Views
13 citations in Web of Science
13 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Orthopedics
Surgery
Logo image