Abstract：
BACKGROUND: Gluteal compartment syndrome is an uncommon entity and physicians may use intracompartmental pressure measurements for confirmation of the clinical diagnosis, or in cases where the physical exam is indeterminate. However, there is a paucity of literature describing a safe and reproducible technique to measure gluteal intracompartmental pressures during the diagnosis of gluteal compartment syndrome. The purpose of this cadaveric study is to evaluate the sole previous technique described in the literature to measure gluteal intracompartmental pressures and provide a modified technique which can be safely and reliably utilized clinically.
METHODS: A cadaveric study with three phases was performed in 16 gluteal regions in 8 cadavers. In the first phase, the previously described technique was assessed. In the second phase, a modified set of techniques was created and evaluated. In the third phase, inter-user reliability of the modified set of techniques was assessed and calculated using Cohen\'s ĸ coefficient. In all three phases, methylene blue was injected through pressure monitoring needles into the gluteus maximus (GMax), gluteus medius/minimus (GMM), and the tensor fascia lata (TFL) compartments. Following dissection, rate of successful penetration into each targeted compartment and distance from the neurovascular structures was recorded.
RESULTS: The previously described set of techniques was found to be variable. The modified set of techniques was effective, successfully reaching the GMax, GMM, and TFL compartments in 100%, 100%, and 81% of attempts, respectively. Inter-user reliability was excellent (ĸ = 1) for the techniques to reach both the GMax and GMM compartments, and moderate (ĸ = 0.54) for the technique to reach the TFL compartment. Within the GMax, the pressure monitoring needle was at a mean of 5.4±0.6 cm, 4.1±0.7 cm, 6.4±0.5 cm from the sciatic nerve (SN), superior gluteal nerve (SGN), and inferior gluteal nerve (IGN), respectively. Within the GMM, the pressure monitoring needle was at a mean of 9.7±1.4 cm, 7.4±1.3 cm, 11.1±1.7 cm from the SN, SGN, and IGN, respectively.
CONCLUSIONS: The modified set of techniques presented allows the three gluteal compartments to be safely and reproducibly reached to measure intracompartmental pressures during the diagnosis of gluteal compartment syndrome.
METHODS: A cadaveric study with three phases was performed in 16 gluteal regions in 8 cadavers. In the first phase, the previously described technique was assessed. In the second phase, a modified set of techniques was created and evaluated. In the third phase, inter-user reliability of the modified set of techniques was assessed and calculated using Cohen\'s ĸ coefficient. In all three phases, methylene blue was injected through pressure monitoring needles into the gluteus maximus (GMax), gluteus medius/minimus (GMM), and the tensor fascia lata (TFL) compartments. Following dissection, rate of successful penetration into each targeted compartment and distance from the neurovascular structures was recorded.
RESULTS: The previously described set of techniques was found to be variable. The modified set of techniques was effective, successfully reaching the GMax, GMM, and TFL compartments in 100%, 100%, and 81% of attempts, respectively. Inter-user reliability was excellent (ĸ = 1) for the techniques to reach both the GMax and GMM compartments, and moderate (ĸ = 0.54) for the technique to reach the TFL compartment. Within the GMax, the pressure monitoring needle was at a mean of 5.4±0.6 cm, 4.1±0.7 cm, 6.4±0.5 cm from the sciatic nerve (SN), superior gluteal nerve (SGN), and inferior gluteal nerve (IGN), respectively. Within the GMM, the pressure monitoring needle was at a mean of 9.7±1.4 cm, 7.4±1.3 cm, 11.1±1.7 cm from the SN, SGN, and IGN, respectively.
CONCLUSIONS: The modified set of techniques presented allows the three gluteal compartments to be safely and reproducibly reached to measure intracompartmental pressures during the diagnosis of gluteal compartment syndrome.
摘要：
背景：臀膜室综合征是一种罕见的实体，医生可以使用房内压力测量来确认临床诊断，或者在体检不确定的情况下。然而,在诊断臀膜室综合征的过程中，缺乏描述安全且可重复的技术来测量臀膜室内压力的文献。这项尸体研究的目的是评估文献中描述的唯一先前技术，以测量臀内压力，并提供一种可以安全，可靠地在临床上使用的改良技术。
方法：对8具尸体的16个臀区进行了三个阶段的尸体研究。在第一阶段,对上述技术进行了评估.在第二阶段,我们创建并评估了一组修改后的技术.在第三阶段,使用科恩的系数评估和计算了修改后的技术集的用户间可靠性。在所有三个阶段，通过压力监测针头将亚甲蓝注入臀大肌（GMax），臀中肌/最小值（GMM），和阔筋膜张量（TFL）隔室。解剖后,记录每个靶向室的成功穿透率和距神经血管结构的距离.
结果：发现先前描述的一组技术是可变的。修改后的一套技术是有效的，成功到达GMax,GMM,和TFL隔室在100%，100%,81%的尝试,分别。对于达到GMax和GMM隔室的技术，用户间可靠性非常出色（r=1），对于到达TFL隔室的技术，中等(Cr=0.54)。在GMax中,压力监测针平均为5.4±0.6厘米，4.1±0.7cm,距坐骨神经（SN）6.4±0.5cm，臀上神经（SGN），和臀下神经（IGN），分别。在GMM中，压力监测针平均为9.7±1.4厘米，7.4±1.3cm,距离SN11.1±1.7cm,SGN,IGN,分别。
结论：所提出的一套改进的技术允许在诊断臀膜室综合征期间安全且可重复地达到三个臀膜室，以测量室内压力。
方法：对8具尸体的16个臀区进行了三个阶段的尸体研究。在第一阶段,对上述技术进行了评估.在第二阶段,我们创建并评估了一组修改后的技术.在第三阶段,使用科恩的
结果：发现先前描述的一组技术是可变的。修改后的一套技术是有效的，成功到达GMax,GMM,和TFL隔室在100%，100%,81%的尝试,分别。对于达到GMax和GMM隔室的技术，用户间可靠性非常出色（r=1），对于到达TFL隔室的技术，中等(Cr=0.54)。在GMax中,压力监测针平均为5.4±0.6厘米，4.1±0.7cm,距坐骨神经（SN）6.4±0.5cm，臀上神经（SGN），和臀下神经（IGN），分别。在GMM中，压力监测针平均为9.7±1.4厘米，7.4±1.3cm,距离SN11.1±1.7cm,SGN,IGN,分别。
结论：所提出的一套改进的技术允许在诊断臀膜室综合征期间安全且可重复地达到三个臀膜室，以测量室内压力。
