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小腿慢性运动性骨筋膜室综合征急性发作的诊断延误

Delay in diagnosis of acute on chronic exertional compartment syndrome of the leg.

作者信息

Uzel André-Pierre, Lebreton Guillaume, Socrier Medhi Lionel

机构信息

Service d'Orthopédie-Traumatologie, CHU Pointe-à-Pitre, Route de Chauvel, 97159, Pointe-à-Pitre Cedex, Guadeloupe, France.

出版信息

Chir Organi Mov. 2009 Dec;93(3):179-82. doi: 10.1007/s12306-009-0043-1. Epub 2009 Nov 12.

Abstract

Exertional compartment syndrome is most commonly described in its chronic form in the young sportive patient. The acute form is a lot rarer and usually only unilateral. We report a case in which a chronic compartment syndrome became acute after intense effort. This was diagnosed rather late due to the lack of knowledge about this syndrome. The necrosis noticed during the fasciotomy was removed by iterative interventions. The wound was left in secondary healing because the patient refused a flap. Upon the patient's last follow-up visit, the wound was healed, but he had a complete deficit in dorsal flexion of the ankle, a foot drop and consequently a step-page gait.

摘要

运动性骨筋膜室综合征在年轻的运动患者中最常表现为慢性形式。急性形式则较为罕见,通常仅为单侧。我们报告一例慢性骨筋膜室综合征在剧烈运动后转变为急性的病例。由于对该综合征认识不足,诊断较晚。在筋膜切开术中发现的坏死组织通过反复干预得以清除。由于患者拒绝皮瓣修复,伤口进行二期愈合。在患者最后一次随访时,伤口已愈合,但他出现了踝关节背屈完全缺失、足下垂,进而导致跨阈步态。

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