Interobserver Variability in the Measurement of Lower Leg Compartment Pressures

Abstract

Objectives: To determine whether interobserver technical variations and errors in the measurement of compartment pressures may affect measurement accuracy.

Methods: Four above-knee cadaveric specimens were used to create a consistent model of lower leg compartment syndrome. Thirty-eight physicians examined the limbs and measured 4 compartment pressures using the Intra-Compartmental Pressure Monitor (Stryker Orthopaedics). They were observed for correct assembly and use of the monitor. Measurements obtained were compared with known pressures.

Results: Of the total number of compartment measurements, 31% were made using the correct technique, 39% were made with lesser errors in technique, and 30% were made with catastrophic errors. Only 60% of measurements made with the correct technique were within 5 mm Hg of the standard pressure. Accuracy dropped to 42% for measurements taken with small errors in technique and 22% when a catastrophic error was committed.

Conclusions: Variations in use of a commercially available pressure monitor exist, and errors are common. Proper use improved accuracy, but even with proper technique, 40% of the measurements were >5 mm Hg from the actual pressure. Based on our data, measurement accuracy with this device should be questioned and viewed within a range. Regular review and education of technique is strongly recommended.