McDougall C G, Johnston G H
Department of Orthopaedics, University of Saskatchewan, Saskatoon, Canada.
J Trauma. 1991 Oct;31(10):1404-7. doi: 10.1097/00005373-199110000-00017.
Hitherto described techniques of catheter placement in the forearm for compartment pressure measurement in the evaluation of forearm compartment syndrome place the underlying neurovascular structures at risk for injury. Based on the cross-sectional anatomy of the forearm, two previously undescribed routes are detailed that provide safer access to the deep volar forearm compartment. Via the ulnar approach, the catheter is inserted medial to the subcutaneous border of the ulna and advanced radially, transversely, skimming over the volar aspect of the ulna into the belly of flexor digitorum profundus. Via the dorsal approach the catheter is inserted radial to the subcutaneous border of the ulna in the supinated forearm. Using the ulna as a guide the catheter is advanced through the dorsal forearm compartment and interosseous membrane into the deep volar compartment. By this route, pressures of both dorsal and volar compartments of the forearm can be measured with a single catheter insertion.
迄今为止，在评估前臂骨筋膜室综合征时，为测量骨筋膜室压力而在前臂放置导管的技术会使潜在的神经血管结构面临受伤风险。基于前臂的横断面解剖结构，详细介绍了两条先前未描述的路径，它们能更安全地进入前臂掌侧深部骨筋膜室。通过尺侧入路，将导管插入尺骨皮下边缘的内侧，然后径向、横向推进，掠过尺骨掌侧进入指深屈肌肌腹。通过背侧入路，在旋前的前臂中，将导管插入尺骨皮下边缘的桡侧。以尺骨为导向，将导管推进穿过前臂背侧骨筋膜室和骨间膜进入掌侧深部骨筋膜室。通过这条路径，单次插入导管即可测量前臂背侧和掌侧骨筋膜室的压力。
