A new technique of catheter placement for measurement of forearm compartment pressures

Hitherto described techniques of catheter placement in the forearm for compartment pressure measurement in the evaluation of forearm compartment syndrome place the underlying neurovascular structures at risk for injury. Based on the cross-sectional anatomy of the forearm, two previously undescribed routes are detailed that provide safer access to the deep volar forearm compartment. Via the ulnar approach, the catheter is inserted medial to the subcutaneous border of the ulna and advanced radially, transversely, skimming over the volar aspect of the ulna into the belly of flexor digitorum profundus. Via the dorsal approach the catheter is inserted radial to the subcutaneous border of the ulna in the supinated forearm. Using the ulna as a guide the catheter is advanced through the dorsal forearm compartment and interosseous membrane into the deep volar compartment. By this route, pressures of both dorsal and volar compartments of the forearm can be measured with a single catheter insertion.