单切口筋膜切开术治疗急性骨筋膜室综合征13例  

13 Cases Clinical Study for Single-Incision Fasciotomy on Treatment of Acute Compartment Syndrome

作　　者：彭海恒 肖卫东[1] 漆白文[1] 喻爱喜[1] PENG Haiheng;XIAO Weidong;QI Baiwen;YU Aixi(Department of Traumatology and Micro-Orthopedics,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院创伤与显微骨科,武汉430071

出　　处：《中国中医骨伤科杂志》2021年第11期65-68,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨单切口筋膜切开术治疗胫腓骨骨折合并急性骨筋膜室综合征的疗效及预后情况。方法:回顾性分析2012年1月至2020年12月收治的胫腓骨骨折合并急性骨筋膜室综合征的13例患者的病例资料,男11例,女2例;平均年龄38.5岁。通过比较伤口闭合时间、植皮需求、植皮面积、术后感染、骨不连、VAS评分、小腿肿胀度、肌肉功能等情况评估预后。结果:患者平均伤口闭合时间为(7.8±7.3)d, 6名患者(46.2%)需要植皮,平均植皮面积为(144.2±256.0)cm^(2);共发生1例感染(7.7%),1例骨不连(7.7%),有2例(15.4%)出现肌肉萎缩,有2例(15.4%)伴随功能障碍;术前VAS评分为(7.7±1.4)分,术后3 d为(1.4±1.0)分,差异有统计学意义(P<0.05);术前小腿肿胀值为(5.2±2.1)cm,术后7 d小腿肿胀值为(2.5±1.7)cm,差异有统计学意义(P<0.05)。结论:单切口筋膜切开术治疗胫腓骨骨折合并急性骨筋膜室综合征,可以彻底减压四个筋膜室,安全有效,并且可以减少皮肤移植。Objective:To explore the efficacy and prognosis of single incision fasciotomy on the treatment of tibia and fibula fractures with acute compartment syndrome.Methods:The case data of 13 patients with tibia and fibula fracture combined with acute compartment syndrome admitted from January 2012 to December 2020 were retrospective analyzed.There were 13 cases in this group, including 11 males and 2 females, with 38.5 years old on average.Wound closure time, skin graft requirements, skin graft area, postoperative infection, nonunion, VAS score, calf swelling, muscle and function were used to assess the prognosis.Results:The average wound closure time of the patients was(7.8±7.3) d.6 patients(46.2%) needed skin grafts, with an average skin graft area of(144.2±256.0) cm^(2).A total of 1 case of infection(7.7%) and 1 case of nonunion(7.7%) occurred.Muscle atrophy occurred in 2 cases(15.4%), and 2 cases(15.4%) were accompanied by dysfunction;the preoperative VAS score was(7.7±1.4) points, and it was(1.4±1.0) points 3 d after operation(P<0.05);the preoperative calf swelling value was(5.2±2.1) cm, and the calf swelling value was(2.5±1.7) cm after 7 d(P<0.05).Conclusion:Single incision fasciotomy for the treatment of tibia and fibula fractures combined with acute compartment syndrome can completely decompress the four compartments, which is safe and effective, and can reduce the need for skin transplantation.

关 键 词：急性骨筋膜室综合征 胫腓骨骨折 骨筋膜室切开减压术 预后 

分 类 号：R687[医药卫生—骨科学]