Croutzet Pierre, Chassat Romain, Masmejean Emmanuel H
Georges Pompidou European Hospital, Paris, France.
Tech Hand Up Extrem Surg. 2009 Sep;13(3):137-40. doi: 10.1097/BTH.0b013e3181aa9193.
Chronic exertional compartment syndrome is now easily identified among the athletic population. It remains common in motorcyclists. The only treatment is the fasciotomy of the compartments and the gold standard procedure is still the open-invasive surgery. The authors describe a new mini-invasive surgical procedure to perform a 4-compartment fasciotomy of the forearm, and expose their results. Over a 3-year period, we reviewed 16 cases of forearm compartment fasciotomy for 8 patients with bilateral chronic exertional compartment syndrome of the forearm who had been operated on. All 8 were males, with an average age of 23 years. All were competition motorcyclists, either in cross-country or speed competitions. They were all treated with the same bilateral procedure: a mini-open fasciotomy of the 4 forearm compartments using the Knifelight, which is a sharp blade between 2 plastic blunt skids originally designed for carpal tunnel release. All patients had resumed their sport in the 6 weeks after the surgery. They were back to their previous level in 3 cases, and improved their level in 5 cases. No complications and no recurrences were reported during an average 2-year follow-up. The mini-invasive technique for fasciotomy seems to be as efficient as the open technique procedure, which is still the gold standard. But the length of surgery, recovery time, and scar sequelae are much better. Mini-invasive surgery is simple, efficient, and the results are reproducible.
慢性运动性骨筋膜室综合征如今在运动员群体中很容易被识别出来。在摩托车骑行者中也较为常见。唯一的治疗方法是骨筋膜室切开术,而金标准手术仍然是开放性侵入性手术。作者描述了一种用于前臂四骨筋膜室切开术的新型微创外科手术,并展示了其结果。在三年时间里,我们回顾了8例双侧前臂慢性运动性骨筋膜室综合征患者接受手术的16例前臂骨筋膜室切开术病例。所有8例均为男性,平均年龄23岁。他们都是参加越野或速度竞赛的职业摩托车手。他们均接受了相同的双侧手术:使用Knifelight对前臂四个骨筋膜室进行微型开放性切开术,Knifelight是一种位于两个塑料钝性滑板之间的锋利刀片,最初设计用于腕管松解术。所有患者在术后6周都恢复了运动。3例恢复到之前的水平,5例提高了水平。在平均两年的随访期间,未报告任何并发症和复发情况。骨筋膜室切开术的微创技术似乎与仍然作为金标准的开放技术手术一样有效。但其手术时长、恢复时间和瘢痕后遗症要好得多。微创手术简单、有效,且结果具有可重复性。