TY  - JOUR
T1  - Near-Infrared Spectroscopy in Lower Extremity Trauma
AU  - Shuler, Michael S.
AU  - Reisman, William M.
AU  - WhitesidesJr., Thomas E.
AU  - Kinsey, Tracy L.
AU  - Hammerberg, E. Mark
AU  - Davila, Maria G.
AU  - Moore, Thomas J.
Y1  - 2009/06/01
N1  - 10.2106/JBJS.H.00347
JO  - The Journal of Bone & Joint Surgery
SP  - 1360
EP  - 1368
VL  - 91
IS  - 6
N2  - Background: Near-infrared spectroscopy measures the percentage of hemoglobin oxygen saturation in the microcirculation of tissue up to 3 cm below the skin. The purpose of this study was to describe the measurable response of normal tissue oxygenation in the leg after acute trauma with use of this technique.Methods: Twenty-six patients with acute unilateral tibial fractures and twenty-five uninjured volunteer control subjects were enrolled. Near-infrared spectroscopy measurements were obtained for both legs in all four compartments: anterior, lateral, deep posterior, and superficial posterior. The twenty-six injured legs were compared with twenty-five uninjured legs (randomly selected) of the volunteer control group, with the contralateral limb in each patient serving as an internal control.Results: The mean tissue oxygenation for each compartment in the injured legs was 69% (anterior), 70% (lateral), 74% (deep posterior), and 70% (superficial posterior). In the control (uninjured) legs, the average tissue oxygenation percentage in each compartment was 54%, 55%, 60%, and 57%, respectively. Repeated-measures analysis revealed that near-infrared spectroscopy values averaged 15.4 percentage points (95% confidence interval, 12.2 to 18.6 percentage points) higher for injured legs than for uninjured legs, controlling for the value of the contralateral limb (p < 0.0001).Conclusions: Tibial fracture produces a predictable increase in tissue oxygenation as measured by near-infrared spectroscopy. The corresponding compartment of the contralateral leg can provide strong utility as an internal control value when evaluating the hyperemic response to injury.Level of Evidence: Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence.
SN  - 0021-9355
M3  - doi: 10.2106/JBJS.H.00347
UR  - http://dx.doi.org/10.2106/JBJS.H.00347
ER  -