Non-invasive assessment of muscle compartment elasticity by pressure-related ultrasound in pediatric trauma: a prospective clinical study in 25 cases of forearm shaft fractures
Abstract Background Soft-tissue swelling after limb fractures in pediatric patients is well known to be a risk factor for developing acute compartment syndrome (ACS). Clinical assessment alone is uncertain in specific cases. Recently, we proposed a non-invasive ultrasound-based method to objectify m...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-023-01232-1 |
| _version_ | 1797577280922320896 |
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| author | R. M. Sellei A. Beckers P. Kobbe A. Weltzien C. D. Weber C. K. Spies N. Reinhardt M. de la Fuente K. Radermacher F. Hildebrand |
| author_facet | R. M. Sellei A. Beckers P. Kobbe A. Weltzien C. D. Weber C. K. Spies N. Reinhardt M. de la Fuente K. Radermacher F. Hildebrand |
| author_sort | R. M. Sellei |
| collection | DOAJ |
| description | Abstract Background Soft-tissue swelling after limb fractures in pediatric patients is well known to be a risk factor for developing acute compartment syndrome (ACS). Clinical assessment alone is uncertain in specific cases. Recently, we proposed a non-invasive ultrasound-based method to objectify muscle compartment elasticity for monitoring. We hypothesize a strong correlation between the soft-tissue swelling after stabilization of upper limb fractures and the compartment elasticity objectified with a novel ultrasound-based approach in pediatric trauma. Patients and methods In a prospective clinical study, children suffering forearm fractures but not developing an ACS were included. The muscle compartment elasticity of the m. flexor carpi ulnaris was assessed after surgical intervention by a non-invasive, ultrasound-based method resulting in a relative elasticity (RE in %) in both the control (healthy limb) and study group (fractured limb). Soft-tissue swelling was categorized in four different levels (0–3) and correlated with the resulting RE (%). Results The RE in the study group (15.67%, SD ± 3.06) showed a significantly decreased level (p < 0.001) compared with the control (22.77%, SD ± 5.4). The categorized grade of soft-tissue swelling resulted in a moderate correlation with the RE (r s = 0.474). Conclusions The presented study appears to represent a novel approach to assess the posttraumatic pressure changes in a muscle compartment after fracture stabilization non-invasively. In this first clinical study in pediatric cases, our measurement method represents a low-cost, easy, and secure approach that has the potential to substitute invasive measurement of suspected ACS in muscle compartment conditions. Further investigations in lager cohorts are required to prove its daily clinical practicability and to confirm the expected reliability. |
| first_indexed | 2024-03-10T22:05:59Z |
| format | Article |
| id | doaj.art-07eadf56078e4afbb03b080945313296 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-03-10T22:05:59Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-07eadf56078e4afbb03b0809453132962023-11-19T12:46:37ZengBMCEuropean Journal of Medical Research2047-783X2023-08-012811710.1186/s40001-023-01232-1Non-invasive assessment of muscle compartment elasticity by pressure-related ultrasound in pediatric trauma: a prospective clinical study in 25 cases of forearm shaft fracturesR. M. Sellei0A. Beckers1P. Kobbe2A. Weltzien3C. D. Weber4C. K. Spies5N. Reinhardt6M. de la Fuente7K. Radermacher8F. Hildebrand9Department of Orthopaedic Trauma, Sana Klinikum OffenbachDepartment of Orthopaedic Trauma, Sana Klinikum OffenbachDepartment of Orthopaedic Trauma and Reconstructive Surgery, University of Aachen Medical CenterDepartment of Pediatric Surgery, Varisano Klinikum HoechstDepartment of Orthopaedic Trauma and Reconstructive Surgery, University of Aachen Medical CenterHand Surgery, Hospital LangenthalChair of Medical Engineering, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen UniversityChair of Medical Engineering, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen UniversityChair of Medical Engineering, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen UniversityDepartment of Orthopaedic Trauma and Reconstructive Surgery, University of Aachen Medical CenterAbstract Background Soft-tissue swelling after limb fractures in pediatric patients is well known to be a risk factor for developing acute compartment syndrome (ACS). Clinical assessment alone is uncertain in specific cases. Recently, we proposed a non-invasive ultrasound-based method to objectify muscle compartment elasticity for monitoring. We hypothesize a strong correlation between the soft-tissue swelling after stabilization of upper limb fractures and the compartment elasticity objectified with a novel ultrasound-based approach in pediatric trauma. Patients and methods In a prospective clinical study, children suffering forearm fractures but not developing an ACS were included. The muscle compartment elasticity of the m. flexor carpi ulnaris was assessed after surgical intervention by a non-invasive, ultrasound-based method resulting in a relative elasticity (RE in %) in both the control (healthy limb) and study group (fractured limb). Soft-tissue swelling was categorized in four different levels (0–3) and correlated with the resulting RE (%). Results The RE in the study group (15.67%, SD ± 3.06) showed a significantly decreased level (p < 0.001) compared with the control (22.77%, SD ± 5.4). The categorized grade of soft-tissue swelling resulted in a moderate correlation with the RE (r s = 0.474). Conclusions The presented study appears to represent a novel approach to assess the posttraumatic pressure changes in a muscle compartment after fracture stabilization non-invasively. In this first clinical study in pediatric cases, our measurement method represents a low-cost, easy, and secure approach that has the potential to substitute invasive measurement of suspected ACS in muscle compartment conditions. Further investigations in lager cohorts are required to prove its daily clinical practicability and to confirm the expected reliability.https://doi.org/10.1186/s40001-023-01232-1Muscle compartmentRelative elasticityPressure-related ultrasoundNon-invasiveAcute compartment syndrome |
| spellingShingle | R. M. Sellei A. Beckers P. Kobbe A. Weltzien C. D. Weber C. K. Spies N. Reinhardt M. de la Fuente K. Radermacher F. Hildebrand Non-invasive assessment of muscle compartment elasticity by pressure-related ultrasound in pediatric trauma: a prospective clinical study in 25 cases of forearm shaft fractures European Journal of Medical Research Muscle compartment Relative elasticity Pressure-related ultrasound Non-invasive Acute compartment syndrome |
| title | Non-invasive assessment of muscle compartment elasticity by pressure-related ultrasound in pediatric trauma: a prospective clinical study in 25 cases of forearm shaft fractures |
| title_full | Non-invasive assessment of muscle compartment elasticity by pressure-related ultrasound in pediatric trauma: a prospective clinical study in 25 cases of forearm shaft fractures |
| title_fullStr | Non-invasive assessment of muscle compartment elasticity by pressure-related ultrasound in pediatric trauma: a prospective clinical study in 25 cases of forearm shaft fractures |
| title_full_unstemmed | Non-invasive assessment of muscle compartment elasticity by pressure-related ultrasound in pediatric trauma: a prospective clinical study in 25 cases of forearm shaft fractures |
| title_short | Non-invasive assessment of muscle compartment elasticity by pressure-related ultrasound in pediatric trauma: a prospective clinical study in 25 cases of forearm shaft fractures |
| title_sort | non invasive assessment of muscle compartment elasticity by pressure related ultrasound in pediatric trauma a prospective clinical study in 25 cases of forearm shaft fractures |
| topic | Muscle compartment Relative elasticity Pressure-related ultrasound Non-invasive Acute compartment syndrome |
| url | https://doi.org/10.1186/s40001-023-01232-1 |
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