Robinson D, On E, Halperin N
Department of Orthopaedic Surgery A, Assaf Harofeh Medical Center, Zerifin, Israel.
J Trauma. 1992 Feb;32(2):183-6. doi: 10.1097/00005373-199202000-00012.
Anterior compartment syndrome of the thigh resulting from blunt contusion without an accompanying fracture is rare. The treatment advocated for it by most authors has been surgical. However, because wound infection rates are high and loss of knee range of motion is frequent, we considered conservative treatment in selected patients. Six athletes who developed an anterior thigh compartment syndrome shortly after sustaining a blunt contusion to the quadriceps with an accompanying massive hematoma were studied prospectively. Tissue pressure, renal function, and creatinine phosphokinase (CPK) levels were closely monitored. Fasciotomy was not performed, despite sustained pressure elevations above 50 mm Hg. Neurologic function was not affected. At follow-up examination 1 year later, no limitation of joint motion nor weakness of the quadriceps were observed. Thus in selected young patients in whom an isolated anterior compartment syndrome of the thigh occurs, conservative treatment yielded results superior to fasciotomy.
由钝挫伤导致的大腿前侧间隔综合征且无骨折伴随情况较为罕见。大多数作者所倡导的针对该病症的治疗方法一直是手术治疗。然而，由于伤口感染率高且膝关节活动范围丧失情况频繁出现，我们考虑对部分患者采用保守治疗。对6名运动员进行了前瞻性研究，这些运动员在股四头肌遭受钝挫伤并伴有大量血肿后不久就出现了大腿前侧间隔综合征。密切监测组织压力、肾功能以及肌酸磷酸激酶（CPK）水平。尽管组织压力持续升高超过50毫米汞柱，但未进行筋膜切开术。神经功能未受影响。在1年后的随访检查中，未观察到关节活动受限或股四头肌无力的情况。因此，对于出现孤立性大腿前侧间隔综合征的特定年轻患者，保守治疗产生了优于筋膜切开术的效果。
