[Measuring pressure in the carpal tunnel in distal radius fracture]

During to the nature of its anatomical locations the median nerve is the nerve most often and most severely affected in compartment syndromes. In our controlled prospective study of 59 patients with distal fractures of the radius, critically high pressure was recorded in the carpal tunnel even in sites of moderate soft tissue swelling. The increase in pressure is directly related to the extent of fracture hematoma, the interval between injury and treatment, and the amount of manipulation during reduction. The average pressure within the carpal tunnel of a normal wrist joint held in the neutral position is 5 mm Hg. In contrast, the average carpal tunnel pressure in the distal radius fracture group in this study was increased to 24 mmHg. During reduction average pressures increase to 44 mmHg, subsequently decrease for a brief period, and finally increase to 34 mmHg 4 h later. At 12 h after reduction average values are still 26 mm Hg. Patients developing Sudeck's dystrophy during treatment (n = 4) exhibit above-average carpal tunnel pressure.