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Effects of Local Compression on Peroneal Nerve Function in HumansA new apparatus was developed to compress the anterior compartment selectively and reproducibly in humans. Thirty-five normal volunteers were studied to determine short-term thresholds of local tissue pressure that produce significant neuromuscular dysfunction. Local tissue fluid pressure adjacent to the deep peroneal nerve was elevated by the compression apparatus and continuously monitored for 2-3 h by the slit catheter technique. Elevation of tissue fluid pressure to within 35-40 mm Hg of diastolic blood pressure (approx. 40 mm Hg of in situ pressure in our subjects) elicited a consistent progression of neuromuscular deterioration including, in order, (a) gradual loss of sensation, as assessed by Semmes-Weinstein monofilaments, (b) subjective complaints, (c) reduced nerve conduction velocity, (d) decreased action potential amplitude of the extensor digitorum brevis muscle, and (e) motor weakness of muscles within the anterior compartment. Generally, higher intracompartment at pressures caused more rapid deterioration of neuromuscular function. In two subjects, when in situ compression levels were 0 and 30 mm Hg, normal neuromuscular function was maintained for 3 h. Threshold pressures for significant dysfunction were not always the same for each functional parameter studied, and the magnitudes of each functional deficit did not always correlate with compression level. This variable tolerance to elevated pressure emphasizes the need to monitor clinical signs and symptoms carefully in the diagnosis of compartment syndromes. The nature of the present studies was short term; longer term compression of myoneural tissues may result in dysfunction at lower pressure thresholds.
Document ID
19970032264
Acquisition Source
Ames Research Center
Document Type
Reprint (Version printed in journal)
External Source(s)
Authors
Hargens, Alan R.
(NASA Ames Research Center Moffett Field, CA United States)
Botte, Michael J.
(California Univ. San Diego, CA United States)
Swenson, Michael R.
(California Univ. San Diego, CA United States)
Gelberman, Richard H.
(Massachusetts General Hospital Boston, MA United States)
Rhoades, Charles E.
(California Univ. San Diego, CA United States)
Akeson, Wayne H.
(California Univ. San Diego, CA United States)
Date Acquired
August 17, 2013
Publication Date
January 1, 1993
Publication Information
Publication: Journal of Orthopaedic Research
Publisher: Orthopaedic Research Society
Volume: 11
Issue: 6
Subject Category
Aerospace Medicine
Report/Patent Number
NASA-CR-204217
NAS 1.26:204217
Accession Number
97N72459
Distribution Limits
Public
Copyright
Public Use Permitted.
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