Can Near Infrared Spectroscopy (NIRS) or Intramuscular Glucose Monitoring Detect Impaired Perfusion in the Anterior Compartment of the Leg in Patients With Tibial Fractures? Proof of Concept Pilot Study

What this Trial Is About

Researchers are evaluating the use of Near Infrared Spectroscopy (NIRS) and intramuscular glucose monitoring to detect impaired blood flow in the anterior compartment of the leg in patients with tibial fractures complicated by acute compartment syndrome or vascular injury. This study aims to determine if these methods can identify reduced tissue oxygenation and relative hypoglycemia compared to the uninjured leg. Currently, NIRS is not a standard tool for monitoring leg fractures, and this research seeks to provide evidence for its clinical use. Adult patients aged 18 to 75 years with unilateral tibial fractures and acute compartment syndrome or vascular compromise are enrolled. After diagnosis confirmation, NIRS sensors are applied to both legs to measure tissue oxygenation until surgery. During surgery, glucose levels are measured directly from muscle tissue and compared to fingerstick glucose levels. Additional monitoring continues for 72 hours post-surgery if possible. Data collection includes ultrasound measurement of muscle depth, compartment pressure, and demographic and surgical details. Participants will undergo bedside ultrasound and NIRS sensor application, blood glucose testing during surgery, and continuous monitoring before and after surgery. Researchers will collect data on oxygenation changes at multiple time points up to 72 hours post-operation. Safety and privacy are maintained with encrypted data storage and de-identification of patient information. The primary outcomes include detecting perfusion changes with NIRS and documenting intramuscular glucose levels as indicators of tissue ischemia during acute compartment syndrome.

Can Near-Infrared Spectroscopy (NIRS) or Intramuscular Glucose Levels Detect Impaired Leg Compartment' Perfusion?