Pozzi Alessandro, Pivato Giorgio, Kask Kristo, Susini Francesca, Pegoli Loris
*Hand and Reconstructive Microsurgery Unit, San Pio X Clinic, Milan, Italy †Orthopedic Department of North Estonia Medical Centre Foundation, Tallinn, Estonia.
Tech Hand Up Extrem Surg. 2014 Sep;18(3):153-6. doi: 10.1097/BTH.0000000000000056.
Chronic exertional compartment syndrome of the forearm is an unusual disease not commonly found in the daily practice of a hand surgeon. This condition is quite rare in the general population but occurs more frequently among musicians and athletes, with the highest incidence found in professional motorcycle drivers. It is mainly because of a critical augmentation of the extracellular pressure of the forearm compartments. The diagnosis is mainly clinical, based on stress dynamic tests and intracompartmental pressure measurements. Traditionally, the treatment of this disease has revolved around trigger activity suspension. In the case of professional athletes, this solution cannot be considered and thus the standard surgical treatment consists of an open forearm fasciotomy. This procedure usually requires a lengthy operation period and has a long recovery time before patients can resume their regular activity. Different surgical endoscopic solutions with mini-open techniques have been proposed to shorten this time and reduce the incision size. The aim of this study was to present a new technique for endoscopic-assisted fasciotomy of the forearm in chronic exertional compartment syndrome using a single mini-incision. Four surgical procedures were performed in 3 patients. They were all treated at our center for this condition, and in one case the disease was found on both sides.
前臂慢性运动性骨筋膜室综合征是一种不常见的疾病，在手外科医生的日常诊疗中并不多见。这种病症在普通人群中相当罕见，但在音乐家和运动员中更为常见，在职业摩托车驾驶员中发病率最高。这主要是由于前臂骨筋膜室的细胞外压力显著增加所致。诊断主要基于临床，依据应力动态试验和骨筋膜室内压力测量。传统上，这种疾病的治疗主要围绕停止引发症状的活动。对于职业运动员而言，这种解决方案不可行，因此标准的外科治疗是开放性前臂筋膜切开术。该手术通常需要较长的手术时间，患者恢复正常活动前的恢复时间也很长。已经提出了不同的采用小切口技术的手术内镜解决方案，以缩短这一时间并减小切口尺寸。本研究的目的是介绍一种使用单一小切口进行慢性运动性骨筋膜室综合征前臂内镜辅助筋膜切开术的新技术。3例患者接受了4次手术。他们均在我们中心接受了这种病症的治疗，其中1例双侧患病。
