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前臂骨筋膜室综合征:一项系统综述

Compartment syndrome of the forearm: a systematic review.

作者信息

Kalyani Bharati S, Fisher Brent E, Roberts Craig S, Giannoudis Peter V

机构信息

Department of Orthopaedic Surgery, University of Louisville, Louisville, KY 40202, USA.

出版信息

J Hand Surg Am. 2011 Mar;36(3):535-43. doi: 10.1016/j.jhsa.2010.12.007.

Abstract

In this systematic review, we examined the available evidence regarding compartment syndrome of the forearm. Applying our inclusion criteria, we found 12 articles for a total of 84 cases using the MEDLINE (Ovid) database. All were retrospective studies (level IV evidence). In this study, papers were analyzed for causes, diagnosis, treatment, methods of wound closure, functional outcome, and complications. The most common cause of compartment syndrome of the forearm in children was a supracondylar fracture, while in adults the most common cause was a fracture of the distal radius. The diagnostic criterion used was clinical assessment alone in 48%, and in 52%, a combination of measurement of intracompartmental pressure and clinical assessment was used. The intracompartmental pressure was measured using various techniques including a wick catheter, slit catheter, the Whitesides technique, and the Stryker compartment pressure measuring device. Fasciotomy was the preferred method of treatment (73%). In cases reporting wound management, postfasciotomy skin grafting was needed in 61% of the cases, whereas secondary closure was performed in 39% of the cases. Neurological deficit was the most common complication (21%).

摘要

在本系统评价中,我们考察了有关前臂骨筋膜室综合征的现有证据。应用我们的纳入标准,我们通过MEDLINE(Ovid)数据库找到了12篇文章,共84例病例。所有研究均为回顾性研究(IV级证据)。在本研究中,对文章进行了病因、诊断、治疗、伤口闭合方法、功能结局及并发症方面的分析。儿童前臂骨筋膜室综合征最常见的病因是肱骨髁上骨折,而成人最常见的病因是桡骨远端骨折。48%的研究仅采用临床评估作为诊断标准,52%的研究采用骨筋膜室内压力测量与临床评估相结合的方法。采用多种技术测量骨筋膜室内压力,包括灯芯导管、狭缝导管、怀特赛兹技术以及史赛克骨筋膜室压力测量装置。筋膜切开术是首选的治疗方法(73%)。在报告伤口处理情况的病例中,61%的病例在筋膜切开术后需要植皮,39%的病例进行了二期缝合。神经功能缺损是最常见的并发症(21%)。

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