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小腿急性骨筋膜室综合征

Acute Compartment Syndrome of the Leg.

作者信息

Konda Sanjit R, Kester Benjamin S, Fisher Nina, Behery Omar A, Crespo Alexander M, Egol Kenneth A

机构信息

*Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY; and †Jamaica Hospital Medical Center, Queens, NY.

出版信息

J Orthop Trauma. 2017 Aug;31 Suppl 3:S17-S18. doi: 10.1097/BOT.0000000000000894.

Abstract

INTRODUCTION

Acute compartment syndrome (ACS) is well known among orthopaedic surgeons. The timely diagnosis and management of ACS is crucial to avoiding its sequelae, including renal failure, ischemic contractures, and limb loss. Despite its relative importance, ACS poses a challenge to many residents and clinicians as diagnosis relies largely on clinical judgment.

METHODS

Timely diagnosis and thorough compartment release are essential to optimizing outcomes in ACS. This video highlights a clinical case in which compartment syndrome of the leg was considered, diagnosed, and surgically managed.

RESULTS

This video will present the indications for compartment release and a video-guided demonstration of compartment checks using an arterial line transducer, a 4-compartment fasciotomy with 2 incisions, and temporizing vessel loop closure.

CONCLUSIONS

Compartment syndrome can be a devastating complication of common fractures. It is essential that orthopaedic practitioners understand the immediacy of intervention. We have a responsibility to provide timely, accurate diagnosis along with expedient surgical management.

摘要

引言

急性骨筋膜室综合征(ACS)在骨科医生中广为人知。ACS的及时诊断和处理对于避免其后遗症至关重要,这些后遗症包括肾衰竭、缺血性挛缩和肢体丧失。尽管ACS相对重要,但它对许多住院医师和临床医生构成了挑战,因为诊断很大程度上依赖于临床判断。

方法

及时诊断和彻底的骨筋膜室切开减压对于优化ACS的治疗效果至关重要。本视频重点介绍了一例考虑、诊断并通过手术处理的小腿骨筋膜室综合征临床病例。

结果

本视频将展示骨筋膜室切开减压的指征,并通过视频指导演示使用动脉测压换能器进行骨筋膜室检查、采用两个切口的四室筋膜切开术以及临时血管环闭合术。

结论

骨筋膜室综合征可能是常见骨折的一种毁灭性并发症。骨科医生必须了解干预的紧迫性。我们有责任提供及时、准确的诊断以及迅速的手术治疗。

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