Biomarkers in the Diagnosis of Acute Compartment Syndrome

Biomarkers of Rhabdomyolysis in the Diagnosis of Acute Compartment Syndrome: Study Protocol of a Prospective Multinational, Multicentre Study in Patients With Tibial Fractures.

This prospective multinational, multicentre cohort study aims to investigate the hypothesis that biomarkers of muscle cell damage can predict acute compartment syndrome in patients with tibial fractures.

Patients with a tibial fracture are included. P-myoglobin and P-creatine phosphokinase are analysed at 6-hourly intervals pre- and if applicable, postoperatively after surgical fixation or fasciotomy. Also, blood samples will be collected in 6 hourly intervals if acute compartment syndrome is suspected. An expert panel of senior orthopaedic surgeons will retrospectively assess study data and classify patients who had undergone fasciotomy into those with and without acute compartment syndrome.

Blood samples will also be collected in patients with acute compartment syndrome without tibial fractures, to serve as a positive control group.

Tibial fracture group

Inclusion Criteria:

- Traumatic tibial fracture

Exclusion Criteria:

• Malignancy
• Acute myocardial infarction
• Kidney failure (GFR ≤35 ml/min)
• Muscle disease
• Paraplegia/tetraplegia

Non-fracture group

Inclusion Criteria:

- Suspected acute compartment syndrome

Exclusion Criteria:

• Malignancy
• Acute myocardial infarction
• Kidney failure (GFR ≤35 ml/min)
• Muscle disease
• Paraplegia/tetraplegia
• Associated fracture
• Acute vascular event