Davidson Donald James, Shaukat Yasir Mehmood, Jenabzadeh Reza, Gupte Chinmay M
Department of T&O, Imperial College Healthcare NHS Trust, London, UK.
BMJ Case Rep. 2013 Dec 17;2013:bcr-2013-202651. doi: 10.1136/bcr-2013-202651.
Spontaneous bilateral compartment syndrome is a very rare condition but one which requires swift diagnosis and urgent surgical decompression by fasciotomies in order to achieve the best outcome. We present the case of a 31-year-old HIV-positive man. The case highlights the perils of being sidetracked by an atypical clinical history instead of acting on the classical clinical examination findings. We will discuss the presentation and management of this patient, review the literature and highlight the key learning points. The most important learning point being that no matter how atypical the history, if a patient presents with limb pain out of proportion to the injury (with or without pain on passive stretch), sensory changes and a loss of motor power, then a diagnosis of acute compartment syndrome must be considered.
自发性双侧骨筋膜室综合征是一种非常罕见的病症，但需要迅速诊断并通过筋膜切开术进行紧急手术减压，以获得最佳治疗效果。我们报告一例31岁的HIV阳性男性病例。该病例凸显了被非典型临床病史误导而非依据经典临床检查结果采取行动的风险。我们将讨论该患者的临床表现及治疗，回顾相关文献并突出关键的经验教训。最重要的经验教训是，无论病史多么不典型，如果患者出现与损伤程度不成比例的肢体疼痛（被动拉伸时有无疼痛）、感觉改变和肌力丧失，那么必须考虑急性骨筋膜室综合征的诊断。
