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小儿足部急性创伤性骨筋膜室综合征:一项系统综述与病例报告

Acute Traumatic Compartment Syndrome in Pediatric Foot: A Systematic Review and Case Report.

作者信息

Wallin Kelly, Nguyen Hienvu, Russell Lindsay, Lee Daniel K

机构信息

Site Director, Foot and Ankle Surgery Residency Program, Postgraduate Year 3, Department of Orthopaedic Surgery, Kaiser Permanente South Sacramento Medical Center, South Sacramento, CA.

Director, Graduate and Undergraduate Medical Education, Kaiser Permanente South Sacramento Medical Center, South Sacramento, CA.

出版信息

J Foot Ankle Surg. 2016 Jul-Aug;55(4):817-20. doi: 10.1053/j.jfas.2016.02.010. Epub 2016 Apr 8.

Abstract

Acute compartment syndrome of the lower leg and foot is a not widely reported, but serious, potential complication that can develop after fractures, crush injuries, or high-velocity trauma of the lower extremity. Early recognition and treatment are critical in preventing morbidity and permanent complications. Although compartment syndrome of the lower leg and foot has been well-studied and documented in adults, its occurrence in the pediatric population is rare. We performed a systematic review of the published data and present the case of the youngest patient with isolated ACS of the foot. A high index of suspicion is warranted in pediatric patients with a traumatic injury to the lower extremity for compartment syndrome. Inconclusive radiographic findings owing to skeletal immaturity and the inability to verbalize symptoms place young children at high risk of undiagnosed compartment syndrome. Clinicians should have a very low threshold for fasciotomy to prevent long-term sequelae associated with undiagnosed compartment syndrome.

摘要

小腿和足部的急性骨筋膜室综合征是一种虽未广泛报道但很严重的潜在并发症,可发生于下肢骨折、挤压伤或高速创伤之后。早期识别和治疗对于预防发病和永久性并发症至关重要。虽然小腿和足部的骨筋膜室综合征在成人中已得到充分研究和记录,但其在儿科人群中的发生却很罕见。我们对已发表的数据进行了系统回顾,并介绍了最年轻的孤立性足部急性骨筋膜室综合征患者的病例。对于有下肢创伤的儿科患者,应高度怀疑骨筋膜室综合征。由于骨骼未成熟导致的影像学检查结果不明确以及无法表达症状,使得幼儿极易发生未被诊断的骨筋膜室综合征。临床医生应将筋膜切开术的阈值设定得很低,以防止与未被诊断的骨筋膜室综合征相关的长期后遗症。

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