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[足部骨筋膜室综合征的早期诊断与治疗]

[Early diagnosis and therapy of osteofascial compartment syndrome of the foot].

作者信息

Zhu Xiang-Jiang, Zhao Yong, Wang Gang-Xiang, Song Nan-Yan, Xu Hong-Yu, Pan Ke-Liang

机构信息

Department of Orthopaedics, Shengzhou People's Hospital, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2009 Nov;22(11):866-7.

Abstract

OBJECTIVE

To investigate the effects of decompresion through double-incision of foot dorsum on the treatment of osteofascial compartment syndrome of the foot under the monitoring of saturation of blood oxygen.

METHODS

From January 2000 to June 2007, 26 cases of osteofascial compartment syndrome of the foot were decompressed through double-incision of foot dorsum under the monitoring of saturation of blood oxygen, and relaxation suture or skin grafting were operated within 3 to 10 days after decompressing. Among them, 22 patients were males and 4 were females, with an average age of 36.3 years old ranging from 22 to 68 years. According to AOFAS system, the pain, function, autonomic activities and support were evaluated.

RESULTS

All patients were followed-up for from 6 to 43 months with the average of 19 months. All patients were healed. According to AOFAS system, the total scores increased from preoperative (30.4 +/- 8.02) to postoperative (92.5 +/- 5.0) (t = 3.13, P < 0.01); the results were excellent in 21 cases, good in 4 and poor in 1.

CONCLUSION

The patients of fracture-dislocated, swelling and injured in the soft tissue because of severe violence should observed closely on osteofascial compartment syndrome of the foot early. Feet are operated and thoroughly decompressed as soon as it is diagnosed as the compartment syndrome. Osteofascial compartment syndrome of the foot decompressed by foot dorsum double-incision is convenient and satisfied, and the operation is performed by internal fixation if it is displacedly fractured at the same time.

摘要

目的

探讨足背双切口减压术在血氧饱和度监测下治疗足部骨筋膜室综合征的效果。

方法

2000年1月至2007年6月,对26例足部骨筋膜室综合征患者在血氧饱和度监测下行足背双切口减压术,并于减压后3至10天内进行减张缝合或植皮。其中男性22例,女性4例,平均年龄36.3岁,年龄范围22至68岁。根据AOFAS系统对疼痛、功能、自主活动及支撑情况进行评估。

结果

所有患者随访6至43个月,平均19个月。所有患者均愈合。根据AOFAS系统,总分由术前的(30.4±8.02)提高至术后的(92.5±5.0)(t = 3.13,P < 0.01);优21例,良4例,差1例。

结论

因严重暴力致骨折脱位、软组织肿胀损伤患者应早期密切观察足部骨筋膜室综合征情况。一旦确诊为骨筋膜室综合征应尽早手术彻底减压。足背双切口减压治疗足部骨筋膜室综合征方便满意,若同时合并有移位骨折则同时行内固定术。

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