TY - JOUR
T1 - Measurement of tissue hardness
T2 - Can this be a method of diagnosing compartment syndrome noninvasively in children?
AU - Joseph, Benjamin
AU - Varghese, Renjit A.
AU - Mulpuri, Kishore
AU - Paravatty, Sujesh
AU - Kamath, Sujata
AU - Nagaraja, N.
PY - 2006/11/1
Y1 - 2006/11/1
N2 - In order to assess the feasibility of using the measurement of tissue hardness as a method of diagnosing compartment syndrome noninvasively in children, a simple hand-held device to measure tissue hardness was fabricated. The relationship between hardness and compartmental pressure was studied in an experimental model and in three fresh amputated lower limbs. Normal tissue hardness of the forearm was measured in 189 children and 20 adults to identify the factors that influence normal tissue hardness. The reproducibility of measurement of tissue hardness was assessed on the experimental model, on the amputated limbs and in normal individuals. Experimental data from this study suggest that there is a nonlinear relationship between intracompartmental pressure and tissue hardness. The study also shows that tissue hardness can be measured reproducibly in the forearm of children with the device. Several factors influence tissue hardness such as the age of the child, the site of measurement on the limb, the hand dominance and active muscle contraction. These factors may affect the specificity of this measure as a screening tool for diagnosing compartment syndrome. Further refinement of the measuring device and well designed clinical trials are needed to establish whether compartmental syndrome can be diagnosed reliably by measuring tissue hardness noninvasively.
AB - In order to assess the feasibility of using the measurement of tissue hardness as a method of diagnosing compartment syndrome noninvasively in children, a simple hand-held device to measure tissue hardness was fabricated. The relationship between hardness and compartmental pressure was studied in an experimental model and in three fresh amputated lower limbs. Normal tissue hardness of the forearm was measured in 189 children and 20 adults to identify the factors that influence normal tissue hardness. The reproducibility of measurement of tissue hardness was assessed on the experimental model, on the amputated limbs and in normal individuals. Experimental data from this study suggest that there is a nonlinear relationship between intracompartmental pressure and tissue hardness. The study also shows that tissue hardness can be measured reproducibly in the forearm of children with the device. Several factors influence tissue hardness such as the age of the child, the site of measurement on the limb, the hand dominance and active muscle contraction. These factors may affect the specificity of this measure as a screening tool for diagnosing compartment syndrome. Further refinement of the measuring device and well designed clinical trials are needed to establish whether compartmental syndrome can be diagnosed reliably by measuring tissue hardness noninvasively.
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U2 - 10.1097/01.bpb.0000236226.21949.5c
DO - 10.1097/01.bpb.0000236226.21949.5c
M3 - Article
C2 - 17001254
AN - SCOPUS:33749024416
SN - 1060-152X
VL - 15
SP - 443
EP - 448
JO - Journal of Pediatric Orthopaedics Part B
JF - Journal of Pediatric Orthopaedics Part B
IS - 6
ER -