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Near Infrared Spectroscopy in the Diagnosis of Chronic Exertional Compartment Syndrome

From the Department of General Surgery, University Medical Center & Central Military Hospital, Utrecht, the Netherlands

^* Address correspondence to Johan G. H. van den Brand, University Medical Center & Central Military Hospital, Utrecht, Department of General Surgery, PO Box 85500, 3508 GA Utrecht, the Netherlands.

Background: Patients with chronic exertional compartment syndrome (CECS) experience pain during exercise. An abnormal increase in intracompartmental pressure (ICP) leads to impaired local tissue perfusion resulting in ischemia and pain. At cessation of exercise, pain subsides. Diagnosis is confirmed through postexercise ICP. Near infrared spectroscopy (NIRS) can measure tissue oxygen saturation (StO₂) noninvasively.

Hypothesis: NIRS can diagnose CECS by showing tissue deoxygenation.

Study Design: Prospective, nonrandomized clinical trial.

Method: Volunteers completed a standardized exercise protocol. Those suspected of CECS did so preoperatively and postoperatively. StO₂ and ICP were monitored. Data were compared between volunteers and patients and prefasciotomy and postfasciotomy.

Results: Significant differences between the StO₂ values of volunteers and patients with CECS were found. Average peak exercise StO₂ value for those with CECS was lower than for the healthy (27 versus 56, P < .05). Patients showed more absolute and percentage change between baseline and peak exercise StO₂ (absolute: 60 versus 35, P < .05; percentage: 67 versus 38, P < .05). StO₂ values in legs with confirmed CECS returned to normal range postfasciotomy. All changes differed significantly with preoperative values.

Conclusion: StO₂ can distinguish healthy from diseased legs. This study provides evidence supporting NIRS as a noninvasive, painless alternative to ICP in the diagnosis of CECS.

Key Words: near infrared spectroscopy • chronic exertional compartment syndrome

This article has been cited by other articles:

				J. G. H. van den Brand, T. Nelson, E. J. M. M. Verleisdonk, and C. van der Werken The Diagnostic Value of Intracompartmental Pressure Measurement, Magnetic Resonance Imaging, and Near-Infrared Spectroscopy in Chronic Exertional Compartment Syndrome: A Prospective Study in 50 Patients Am. J. Sports Med., May 1, 2005; 33(5): 699 - 704. [Abstract] [Full Text] [PDF]