Geske B, Jerosch J, Reifenrath M
Orthopädische Klinik, Universität Düsseldorf.
Dtsch Med Wochenschr. 1991 Mar 8;116(10):375-8. doi: 10.1055/s-2008-1063623.
A 67-year-old woman, having been hit in the lower leg by a car bumper in a road accident, developed a compartment syndrome in the lower leg without any bone injury. In the following weeks typical contractures of the affected muscles occurred with talipes equinus and clawfoot deformities. In addition there developed insertion tendinitis of the affected muscle groups of the anterior tibia. A year later magnetic resonance imaging (with normal radiological findings) revealed fatty degeneration and muscle fibrosis. The patient complained of pain at rest and on movement in the proximal tibia, and there was definite pain on pressure over the proximal end of the tibia. Conservative treatment having failed, the Achilles tendon and the long flexor muscle of the toes were lengthened by operation. Both signs and symptoms then improved. A compartment syndrome may develop after blunt trauma even in the absence of bony injury. If there are the appropriate clinical signs, intracompartmental pressure measurement is the procedure of choice to confirm the diagnosis quickly and thus avoid sequelae.
一名67岁女性在道路交通事故中被汽车保险杠撞到小腿,小腿出现骨筋膜室综合征,但无任何骨损伤。在接下来的几周里,受影响的肌肉出现了典型的挛缩,伴有马蹄足和爪形足畸形。此外,胫骨前部受影响的肌肉群出现了附着点肌腱炎。一年后,磁共振成像(放射学检查结果正常)显示脂肪变性和肌肉纤维化。患者主诉胫骨近端休息和活动时疼痛,胫骨近端压痛明显。保守治疗失败后,通过手术延长了跟腱和趾长屈肌。此后症状和体征均有所改善。即使没有骨损伤,钝性创伤后也可能发生骨筋膜室综合征。如果出现适当的临床体征,测量骨筋膜室内压力是快速确诊并避免后遗症的首选方法。