Measure the Intracompartmental Pressure Changes in Intramedullary Nailing of Tibia: A Cross Sectional Study

Background: Tibial shaft fractures are common in orthopedic trauma, and intramedullary nailing (IMN) is a standard treatment. However, compartment syndrome remains a serious complication. This study aimed to evaluate intracompartmental pressure (ICP) changes during IMN of tibial fractures. Material & Methods: A cross-sectional observational study was conducted among 35 adult patients with traumatic tibial diaphyseal fractures who underwent IMN. ICP measurements were taken preoperatively, intraoperatively, and postoperatively using a Stryker pressure monitor. Delta pressure (ΔP) calculations were used to assess ischemic risk. Results: The study revealed significant fluctuations in ICP across surgical phases (p < 0.05). Females experienced a progressive increase in compartment pressure (CP) from preoperative to postoperative phases (39.8 mmHg to 49.2 mmHg), whereas males exhibited an initial increase followed by a slight decrease postoperatively (37.1 mmHg to 42.0 mmHg). Sex-based differences in postoperative CP trends were notable (p < 0.05). Preoperative delta pressure (ΔP) correlated with intraoperative and postoperative CP fluctuations. All patients had intact neurological and vascular function postoperatively. Conclusion: This study highlights the importance of individualized perioperative ICPmonitoring strategies, particularly for high-risk patients. Sex-based differences and mechanism of injury influence ICP changes, and understanding these variations can help prevent compartment syndrome and ischemic complications. The findings contribute to refining perioperative management protocols in orthopedic trauma surgery. Delta pressure.