I would like to call your attention to an error contained in the article titled “Trauma Tips for the Orthopaedic Surgeon,” which appeared in the June 2019 issue of AAOS Now and discussed material presented on compartment syndrome.

When measuring compartment pressures, the preinduction diastolic blood pressure is used, not the systolic blood pressure. This concept is extremely important to get right, as compartment pressures will rarely ever be within 30 mmHg of the systolic pressure.

Orthopaedic surgeons, along with general and vascular surgeons, should understand the delta P calculation:

Preinduction pressure – intracompartmental pressure = 30 mmHg or less = compartment syndrome

The use of this calculation notwithstanding, compartment syndrome is truly a clinical diagnosis, and there should be no delay to fasciotomy if clinical concern for compartment syndrome is high.

See: Köstler W, Strohm PC, Südkamp NP: Acute compartment syndrome of the limb. Injury 2004;35:1221-7.

Perry J. Evangelista, MD
Evangelista Orthopedic Clinic Scottsdale, Ariz.