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Monitoring antebrachial compartmental pressure in displaced supracondylar elbow fractures in children

Purpose Our aim was to measure antebrachial volar compartment pressure in displaced supracondylar elbow fractures in children. Methods We conducted a prospective, observational study of 42 fractures. The mean age was 5.2 years. There was type II displacement in nine cases (21.4%) and type III in 33 (78.6%). A wick catheter (1.5 mm in diameter) was placed perioperatively and compartmental pressure was monitored on a intra-compartmental pressure monitor system (STIC monitor) with a ±1 mmHg margin of error. Compartmental, systolic and diastolic pressures were measured every day for the first three postoperative days and then for a 2-week follow-up period. Descriptive statistics, t-test and correlation with a P<0.05 significance were studied. Results Mean compartmental pressure before reduction was 8.3 mmHg and 6.7, 4, 2.4, 1.7 and 1 mmHg during the first 3 days and at 1 and 2 weeks post-reduction, respectively. Pressure decreased 40% (P=0.0005) from the first to the second day and 75% (P=0.0005) from the first day to the first week. There was no correlation between compartmental pressure and systolic and diastolic pressure. The compartmental pressure decreased significantly by the third postoperative day (P=0.02). Conclusion Compartmental pressure decreased 60% the first 3 days. In displaced supracondylar fractures with clinical risk factors, it is advisable to monitor compartmental pressure during the first 24–48 h.