Intracompartmental pressures were measured by the wick catheter
technique in sixty-five compartments of twenty-seven patients who were
clinically suspected of having acute compartment syndromes. A pressure of
thirty millimeters of mercury or more was used as an indication for
decompressive fasciotomy. The range of normal pressure was from zero to
eight millimeters of mercury. Eleven of these patients were diagnosed as
actually having compartment syndromes and in these patients, twenty-seven
compartments were decompressed. Only two patients had significant sequelae.
In the sixteen patients (thirty-eight compartments) whose pressures
remained less than thirty millimeters of mercury, fasciotomy was withheld
and compartment syndrome sequelae did not develop in any patient.
Intraoperatively the wick catheter was used continuously in eight patients
to document the effectiveness of decompression. Fasciotomy consistently
restored pressures to normal except in the buttock and deltoid
compartments, where epimysiotomy was required to supplement the fasciotomy.
Continuous intraoperative monitoring of pressure by the wick catheter
technique allowed us to select the few cases in which primary closure of
wounds was appropriate and to decide which patients were best treated with
secondary closure.