Mitsiokapa Evanthia A, Mavrogenis Andreas F, Salacha Andromachi, Tzanos George
Department of Physical Medicine and Rehabilitation, General University Hospital of Patras, Greece.
J Surg Orthop Adv. 2013 Summer;22(2):168-72. doi: 10.3113/jsoa.2013.0168.
Acute lumbosacral plexus injury from gluteal compartment syndrome is extremely rare. Physicians should be aware of this diagnosis when examining patients with altered mental status, prolonged immobilization, and gluteal muscle compression. This case report presents a patient with acute complete left lumbosacral plexus paralysis and acute renal failure after gluteal compartment syndrome secondary to prolonged immobilization from drug abuse. Clinical examination, imaging of the pelvis, renal function, creatine phosphokinase, and urine myoglobin were indicative of gluteal compartment syndrome and rhabdomyolysis. Electrodiagnostic studies showed complete limb paralysis. Medical treatment and rehabilitation was administered. Renal function recovered within the 1st week; function at the proximal muscles of the left lower limb improved within 6 months, with mild discomfort on sitting at the buttock, foot drop, and sensory deficits at the leg and dorsum of foot.
臀肌间室综合征导致的急性腰骶丛损伤极为罕见。在检查意识状态改变、长期制动及臀肌受压的患者时,医生应警惕这一诊断。本病例报告介绍了一名患者,因药物滥用导致长期制动继发臀肌间室综合征后,出现急性完全性左腰骶丛麻痹和急性肾衰竭。临床检查、骨盆影像学检查、肾功能、肌酸磷酸激酶及尿肌红蛋白检查均提示臀肌间室综合征和横纹肌溶解。电诊断研究显示肢体完全麻痹。给予了药物治疗和康复治疗。肾功能在第1周内恢复;左下肢近端肌肉功能在6个月内有所改善,但仍存在臀部坐位时轻度不适、足下垂以及小腿和足背感觉障碍。