NIRST and ICG-based Perfusion Imaging in Acute Compartment Syndrome

This is a prospective observational study of patients with suspected Acute Compartment Syndrome. The primary objective of this work is to determine whether intensity changes associated with the NIRST signal, reflecting oxy- and deoxy-hemaglobin and water concentrations or ICG fluorescence signal, reflecting tissue perfusion, can be associated with development of Acute Compartment Syndrome and identification of at-risk soft tissue and muscle.

Inclusion Criteria:Age 18 years or olderClinical suspicion of acute compartment syndrome based on orthopaedic provider assessment. Clinical suspicion would be based upon the presence of one or more of these findings:Pain out of proportion to visible findingsEscalating doses of pain medicationPain with passive stretch of toes and/or fingersPallor, paresthesias, pulselessnessTense soft tissuesHigh energy tibia or forearm fractureProvision of informed consentExclusion Criteria:History of allergy to ICG and/or iodinePregnant women or nursing mothersAny patient with an open wound for whom NIRST device cannot be applied >4cm from the open wound will be excluded from NIRST imaging.