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Updated: Apr 25, 2026

$Pseudofracture: An Acute Peripheral Tissue Trauma Model$

Pseudofracture: An Acute Peripheral Tissue Trauma Model

Published on: April 18, 2011

Subcutaneous depth in a traumatized lower extremity.

Mellisa Roskosky¹, Gillian Robinson, William Reisman

¹From the Athens Orthopedic Clinic (M.R., M.S.S.), Athens, Georgia; The Geneva Foundation (M.R., G.R.), Tacoma, Washington; Emory School of Medicine (W.R.), Atlanta, Georgia; Atlanta Medical Center (B.Z.), Atlanta, Georgia; and Landstuhl Regional Medical Center (B.F.), Landstuhl, Germany.

The Journal of Trauma and Acute Care Surgery

|August 28, 2014

Summary

Near-infrared spectroscopy (NIRS) can accurately assess leg compartment oxygenation in traumatic injuries. Subcutaneous tissue depth in injured legs, even with swelling, does not impede NIRS measurements for diagnosing acute compartment syndrome.

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Area of Science:

Orthopedics
Trauma Surgery
Biomedical Engineering

Background:

Acute compartment syndrome is a severe complication of leg trauma.
Near-infrared spectroscopy (NIRS) measures tissue oxygenation but its efficacy in swollen or obese legs is questioned.
NIRS depth penetration is typically 2-3 cm.

Purpose of the Study:

To measure subcutaneous tissue thickness in the leg's posterior compartment in patients with tibia fractures.
To determine if tissue thickness compromises NIRS measurements for muscle oxygenation.

Main Methods:

Ultrasound measurements of skin-to-fascia distance in 50 patients with severe leg injuries.
Analysis of subcutaneous adipose tissue thickness (ATT) in injured and uninjured legs.
Correlation analysis with body mass index (BMI).

Main Results:

Mean ATT was approximately 7 mm in both injured and uninjured legs.
No significant correlation between ATT and BMI.
No subject exceeded 2 cm subcutaneous depth, suggesting NIRS feasibility.
No difference in ATT between injured and uninjured legs.

Conclusions:

Swelling and edema in traumatically injured legs do not significantly alter skin-to-fascia distance.
Subcutaneous depth exceeding 2 cm is uncommon in this population.
Continuous NIRS monitoring is supported for diagnosing acute compartment syndrome in leg injuries.