How Moo Ing, Lee Puah Ken, Wei Tan See, Chong Chua Tai
Department of Orthopaedics Surgery, Changi General Hospital, Singapore.
Department of Rehabilitative Medicine, University Malaya Medical Centre, Malaysia.
Int J Surg Case Rep. 2015;11:56-58. doi: 10.1016/j.ijscr.2015.04.003. Epub 2015 Apr 8.
Compartment syndrome isolated to the anterior thigh is a rare complication of soccer injury. Previous reports in the English literature on sports trauma-related compartment syndrome of the thigh are vague in their description of the response of thigh musculature to blunt trauma, magnetic resonance imaging (MRI) findings of high-risk features of compartment syndrome, vascular injury in quadriceps trauma, and the role of vascular study in blunt thigh injury.
We present herein the rare case of a 30-year-old man who developed thigh compartment syndrome 8 days after soccer injury due to severe edema of vastus intermedius and large thigh hematoma secondary to rupture of the profunda femoris vein. MRI revealed "blow-out" rupture of the vastus lateralis. Decompressive fasciotomy and vein repair performed with subsequent split-skin grafting of the wound defect resulted in a good functional outcome at 2-years follow-up.
A high index of suspicion for compartment syndrome is needed in all severe quadriceps contusion. Vascular injury can cause thigh compartment syndrome in sports trauma. MRI findings of deep thigh muscle swelling and "blow-out" tear of the vastus lateralis are strongly suggestive of severe quadriceps injury, and may be a harbinger of delayed thigh compartment syndrome.
孤立于大腿前侧的骨筋膜室综合征是足球运动损伤中一种罕见的并发症。英文文献中先前关于与运动创伤相关的大腿骨筋膜室综合征的报道，在描述大腿肌肉组织对钝性创伤的反应、骨筋膜室综合征高危特征的磁共振成像（MRI）表现、股四头肌创伤中的血管损伤以及血管检查在大腿钝性损伤中的作用时都很模糊。
我们在此呈现一例罕见病例，一名30岁男性在足球运动损伤8天后因股中间肌严重水肿和股深静脉破裂继发大腿巨大血肿而发生大腿骨筋膜室综合征。MRI显示股外侧肌“爆裂性”断裂。进行了减压筋膜切开术和静脉修复，随后对伤口缺损进行了分层皮片移植，在2年随访时获得了良好的功能结果。
对于所有严重的股四头肌挫伤都需要高度怀疑骨筋膜室综合征。血管损伤可导致运动创伤中的大腿骨筋膜室综合征。大腿深部肌肉肿胀以及股外侧肌“爆裂性”撕裂的MRI表现强烈提示严重的股四头肌损伤，可能是延迟性大腿骨筋膜室综合征的先兆。
