At what pressure is operative decompression of a compartment mandatory?
A. 15 mm HgIn comatose or obtunded patients, the diagnosis is more difficult to secure. A compatible history, firmness of the compartment to palpation, and diminished mobility of the joint are suggestive. The presence or absence of a pulse distal to the affected compartment is notoriously unreliable in the diagnosis of a compartment syndrome. A frozen joint and myoglobinuria are late signs and suggest a poor prognosis. As in the abdomen, compartment pressure can be measured. The small, hand-held Stryker device is a convenient tool for this purpose. Pressures greater than 45 mm Hg usually require operative intervention. Patients with pressures between 30 and 45 mm Hg should be carefully evaluated and closely watched.