de Fijter Wijand Marnixde, Scheltinga Marcus Reinoud, Luiting Martinus G
Department of Surgery, Maxima Medical Center, Veldhoven, The Netherlands.
Mil Med. 2006 May;171(5):399-403. doi: 10.7205/milmed.171.5.399.
This study evaluated the efficacy of a minimally invasive percutaneous fasciotomy in chronic exertional compartment syndrome and fascial hernias of the anterior lower leg (N = 118). Approximately one-third of symptomatic legs (n = 41) demonstrated fascial herniation and underwent fasciotomy without compartment pressure measurements via a small percutaneous incision using a fasciotome. Symptomatic legs with an intact fascia (n = 77) received similar operative treatment based on pressure measurements. Relief of symptoms was obtained in all but two patients. Postoperative complications included hematoma (9%), superficial peroneal nerve injury (2%), anterior ankle pain (5%), and recurrence (2%). Most patients (96%) reported unlimited exercise after a mean follow-up of 62 months. However, mild symptoms associated with nerve injury as well as ankle pain persisted (4%). A minimally invasive fasciotomy of the anterior lower leg harboring fascial hernias or a chronic exertional compartment syndrome is effective. Complications such as nerve injury and anterior ankle pain may be related to a too distally performed fasciotomy.
本研究评估了微创经皮筋膜切开术治疗慢性运动性骨筋膜室综合征及小腿前外侧筋膜疝（N = 118）的疗效。约三分之一有症状的下肢（n = 41）表现为筋膜疝，通过使用筋膜刀经皮小切口进行筋膜切开术，未进行骨筋膜室压力测量。筋膜完整的有症状下肢（n = 77）根据压力测量结果接受了类似的手术治疗。除两名患者外，所有患者症状均得到缓解。术后并发症包括血肿（9%）、腓浅神经损伤（2%）、踝关节前部疼痛（5%）和复发（2%）。大多数患者（96%）在平均随访62个月后报告可进行无限制运动。然而，与神经损伤以及踝关节疼痛相关的轻微症状仍然存在（4%）。对于存在筋膜疝或慢性运动性骨筋膜室综合征的小腿前外侧进行微创筋膜切开术是有效的。诸如神经损伤和踝关节前部疼痛等并发症可能与筋膜切开术操作位置过于靠远侧有关。
