足部外伤合并筋膜间室综合征的诊治  

The diagnosis and treatment of compartment syndrome after foot injury

作　　者：韩建华[1] 陈明[1] 李之斌[1] 乔利亚 阮建伟[1] 

机构地区：[1]台州市立医院骨科,浙江台州318000

出　　处：《临床骨科杂志》2003年第3期224-225,共2页Journal of Clinical Orthopaedics

摘　　要：目的　探讨足部损伤合并肌筋膜间室综合征诊断及治疗方法。方法　对 12 8例较严重的足部闭合性损伤患者 ,应用Whiteside法行足部肌筋膜间室内压力监测 ,其中 12例间室内平均压力为 5 3(4 0～ 6 6 )kPa ,行前足背侧及足后内侧入路肌筋膜间室切开减压术 ,同时行骨折复位克氏针及斯氏针内固定术。术后继续监测各筋膜间室内压力 ,术后 5 7d行刃厚皮片覆盖创面。结果　 10例患者平均随访 18(12～ 2 4 )个月。 3例行走或站立时间过长时足弓部及足跟部疼痛 ,其中 1例出现前足僵硬、爪形趾、软组织萎缩及运动功能异常 ;其余 7例足部功能正常 ,恢复正常工作。结论　对于较严重的闭合性足部损伤 ,肌筋膜间室内压测定是诊断足部肌筋膜间室综合征的可靠方法 。Objective To explore the diagnosis and treatment of compartment syndrome after foot injury. Methods For 128 patients with severe foot closed injury, the intracompartmemtal pressure of foot were measured with the Witeside’s method. The pressure in 12 patients averaged 5 3 kPa(range from 4 0 to 6 6 kPa), which were treated with fasciotomy through medial incision of dorsal forefoot and hindfoot, open reduction and internal fixation with Kirschner wire and Steinmann pin. The intracompartment pressure were continously monitored after operation. After 5~7 d, the wounds were covered with a split thinkness skin graft. Results 10 patients were followed up for a mean of 18 months (range from 12 to 24 months ). 3 of the patients had occasional hindfoot and ankle pain after walking or standing for a long time, 1 of which developed stiffness of the forefoot, claw toes, soft tissue atrophy and abnormal of motor function. Conclusion It should not be neglected that the compartment syndrome of the foot may occur after severe closed injury. Intracompartment pressure measurements should be performed to confirm the diagnosis and decompression should be given according to the intracompartment pressure.

关 键 词：足损伤 筋膜间隔综合征 诊断 治疗 

分 类 号：R658.3[医药卫生—外科学] R685[医药卫生—临床医学]