Richter Jens, Schulze Wito, Klaas Astrid, Clasbrummel Berhard, Muhr Gert
Chirurgische Universitätsklinik Bergmannsheil, Ruhr-University, Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany.
Arch Orthop Trauma Surg. 2008 Feb;128(2):199-204. doi: 10.1007/s00402-007-0522-5. Epub 2007 Nov 27.
Using a cadaver model and multiple continuous compartment pressure measurement, we sought to determine the pressure distribution in different osseofascial spaces of the foot and determine the quickest and most effective technique of pressure release.
The compartment pressures were measured (in mmHg) in five different osseofascial spaces of each foot. In stepwise manner, warmed saline was injected only into the central compartment only. Three experimental approaches to fasciotomy were studied.
We recognized a simultaneous exponential increase of all foot compartments in all experimental models. With a medial fasciotomy technique first, a flexor brevis compartment incision was necessary to release pressures in the central compartments. Following this procedure, pressure was released in the tarsal tunnel and in the intermetatarsal area immediately. Pressure reduction in the central flexor space and in the tarsal tunnel was less effective with a dorsal fasciotomy technique.
There is no pressure increase of a "single" osseofascial space in case of a foot compartment syndrome. If immediate pressure release is required, a medial fasciotomy technique including the central flexors should be favoured.
我们使用尸体模型和多次连续间隔压力测量，试图确定足部不同骨筋膜间隙的压力分布，并确定最快且最有效的减压技术。
测量每只脚五个不同骨筋膜间隙的间隔压力（以毫米汞柱为单位）。逐步仅向中央间隙注入温热盐水。研究了三种筋膜切开术的实验方法。
我们发现在所有实验模型中，足部所有间隙压力同时呈指数级增加。首先采用内侧筋膜切开术时，需要切开短屈肌间隙以释放中央间隙的压力。在此操作之后，跗管和跖骨间隙的压力立即得到释放。采用背侧筋膜切开术时，中央屈肌间隙和跗管内的压力降低效果较差。
足部间隔综合征时，不存在“单一”骨筋膜间隙压力升高的情况。如果需要立即减压，应优先采用包括中央屈肌的内侧筋膜切开术。
