Vibratory sensory testing in acute compartment syndromes: a clinical and experimental study

Invasive and noninvasive diagnostic testing was correlated in 11 patients with acute compartmental syndromes of the forearm. The excellent correlation between diminished perception of vibration and increasing compartmental pressure suggested that 256 cycle per second (cps) vibratory stimuli may be useful clinically in determining the appropriate time for surgical intervention in the acute compartmental syndrome. In 12 adult male volunteers, elevated compartment pressures were created in the anterior tibial compartment of the leg. A decrease in perception to 256 cycle per second (cps) vibratory stimulus was the earliest sensory abnormality to occur with elevated tissue compartment pressures. Analysis of variance showed significantly that 256-cps vibration was the most reliable and earliest sensory modality to change at pressures of 35 to 40 mmHg. These clinical and experimental findings support the use of the 256-cps tuning fork as a noninvasive diagnostic test in the evaluation of the patient with suspected acute compartment syndrome.