Keskinbora Mert, Yalçin Sercan, Oltulu İsmail, Erdil Mehmet Emin, Örmeci Tuğrul
Department of Orthopaedics and Traumatology, İstanbul Medipol University, Istanbul, Turkey.
Department of Radiology, İstanbul Medipol University, Istanbul, Turkey.
Clin Orthop Surg. 2016 Mar;8(1):115-8. doi: 10.4055/cios.2016.8.1.115. Epub 2016 Feb 13.
Gunshot injuries are getting more frequently reported while the civilian (nongovernmental) armament increases in the world. A 42-year-old male patient presented to emergency room of Istanbul Medipol University Hospital due to a low-velocity gunshot injury. We detected one entry point on the posterior aspect of the thigh, just superior to the popliteal groove. No exit wound was detected on his physical examination. There was swelling around the knee and range of motion was limited due to pain and swelling. Neurological and vascular examinations were intact. Following the initial assessment, the vascular examination was confirmed by doppler ultrasonography of the related extremity. There were no signs of compartment syndrome in the preoperative physical examination. A bullet was detected in the knee joint on the initial X-rays. Immediately after releasing the tourniquet, swelling of the anterolateral compartment of the leg and pulse deficiency was detected on foot in the dorsalis pedis artery. Although the arthroscopic removal of intra-articular bullets following gunshot injuries seems to have low morbidity rates, it should always be considered that the articular capsule may have been ruptured and the fluids used during the operation may leak into surrounding tissues and result in compartment syndrome.
随着全球民用(非政府)军备增加,枪伤报告愈发频繁。一名42岁男性患者因低速枪伤被送至伊斯坦布尔梅迪波尔大学医院急诊室。我们在大腿后侧、腘窝沟上方发现一个入口。体格检查未发现出口伤口。膝关节周围肿胀,因疼痛和肿胀活动范围受限。神经和血管检查未见异常。初步评估后,通过对相关肢体进行多普勒超声检查确认血管情况。术前体格检查未发现骨筋膜室综合征迹象。初次X线检查发现膝关节内有一枚子弹。松开止血带后,立即发现小腿前外侧骨筋膜室肿胀,足背动脉搏动消失。尽管枪伤后关节镜下取出关节内子弹的发病率似乎较低,但应始终考虑关节囊可能已破裂,手术中使用的液体可能渗入周围组织并导致骨筋膜室综合征。