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Journal of Orthopaedic Surgery and Research

, 3:14

First Online: 17 April 2008Received: 20 July 2007Accepted: 17 April 2008

Abstract

BackgroundThe severity of associated soft tissue trauma in complex injuries of the extremities guides fracture treatment and decisively determines patient-s prognosis. Trauma-induced microvascular dysfunction and increased tissue pressure is known to trigger secondary soft tissue damage and seems to adversely affect skeletal muscle function.

Methods20 patients with isolated tibial fractures were included. Blood pressure and compartment pressure anterior and deep posterior compartment were measured continuously up to 24 hours. Corresponding perfusion pressure was calculated. After 4 and 12 weeks isokinetic muscle peak torque and mean power of the ankle joint in dorsal and plantar flexion were measured using a Biodex dynamometer.

ResultsA significant inverse correlation between the anterior perfusion pressure at 24 hours and deficit in dorsiflexion at 4 weeks was found for both, the peak torque R = -0.83; p < 0.01 and the mean power R = -0.84; p < 0.01. The posterior perfusion pressure at 24 h and the plantar flexion after 4 weeks in both, peak torque R = -0.73, p =< 0.05 and mean power R = -0.7, p =< 0.05 displayed a significant correlation.

ConclusionThe functional relationship between the decrease in intramuscular perfusion pressures and muscle performance in the early rehabilitation period indicate a causative and prognostic role of early posttraumatic microcirculatory derangements and skeletal muscle function. Therapeutic concepts aimed at effective muscle recovery, early rehabilitation, and decreased secondary tissue damage, should consider the maintenance of an adequate intramuscular perfusion pressure.

Electronic supplementary materialThe online version of this article doi:10.1186-1749-799X-3-14 contains supplementary material, which is available to authorized users.

Michael Müller, Aleaxander C Disch contributed equally to this work.

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Autor: Michael Müller - Aleaxander C Disch - Nicole Zabel - Norbert P Haas - Klaus D Schaser

Fuente: https://link.springer.com/



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