Intramuscular pressure in the lower leg in deep vein thrombosis and phlegmasia cerulae dolens

The influence of deep vein thrombosis on intramuscular pressure was evaluated in 22 patients by means of the wick technique. Intramuscular pressure was measured in the anterior tibial and the deep posterior compartments in both legs before and during treatment. The intramuscular pressure was significantly (p less than 0.001) higher in the thrombosed leg than in the contralateral leg (0-16 mmHg). The increase in intramuscular pressure was related to the extension of the thrombus. Iliofemoral thrombosis caused a significantly (p less than 0.001) higher pressure (17-28 mmHg) than calf thrombosis (16-23 mmHg). A compartment syndrome was found to be a part of the entity phlegmasia cerulea dolens (rest pressure 47-56 mmHg). In the treatment of phlegmasia cerulea dolens, fasciotomy is suggested additional to other therapeutic procedures.