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内镜下筋膜松解术治疗前臂慢性运动性骨筋膜室综合征:病例报告及手术技术

Endoscopic Fascia Release for Forearm Chronic Exertional Compartment Syndrome: Case Report and Surgical Technique.

作者信息

Miller Elizabeth A, Cobb Anna L, Cobb Tyson K

机构信息

1 Orthopaedic Specialists, P.C., Davenport, IA, USA.

出版信息

Hand (N Y). 2017 Sep;12(5):NP58-NP61. doi: 10.1177/1558944716669799. Epub 2016 Sep 16.

Abstract

BACKGROUND

Chronic exertional compartment syndrome (CECS) of the forearm is traditionally treated with open compartment release requiring large incisions that can result in less than optimal esthetic results. The purpose of this study is to describe a case report of 2 professional motocross patients with forearm CECS treated endoscopically using a minimally invasive technique.

METHODS

Two professional motocross racers presented with a history of chronic proximal volar forearm pain when motocross riding. Other symptoms included paresthesia and weakness, which, at times, led to an inability to continue riding. Both failed conservative management. Compartment pressure measurements were performed before and after provocative exercises to confirm diagnosis of CECS. Release of both the volar and dorsal compartments was performed endoscopically through a single incision.

RESULTS

Symptoms resolved after surgery. The first patient resumed riding at 1 week, competing at 3 weeks, and continues to ride competitively without symptoms at 3 years postoperative. The second patient began riding at 1 week and won second place in the National Supercross finals 5 weeks after simultaneous bilateral release.

CONCLUSIONS

This technique is simple and effective. The cannula used protects the superficial nerves while allowing release through a small, cosmetically pleasing incision.

摘要

背景

传统上,前臂慢性运动性骨筋膜室综合征(CECS)采用切开骨筋膜室减压术治疗,该手术需要做大切口,可能导致美学效果欠佳。本研究的目的是描述2例职业摩托车越野赛运动员前臂CECS患者采用微创技术进行内镜治疗的病例报告。

方法

2例职业摩托车越野赛选手在进行摩托车越野赛时均有慢性前臂掌侧近端疼痛病史。其他症状包括感觉异常和无力,有时会导致无法继续骑行。两人保守治疗均失败。在激发试验前后进行骨筋膜室内压力测量以确诊CECS。通过单一切口在内镜下对掌侧和背侧骨筋膜室进行减压。

结果

术后症状消失。第一例患者术后1周恢复骑行,3周参加比赛,术后3年继续参加比赛且无症状。第二例患者术后1周开始骑行,双侧同时减压术后5周在全国超级越野赛决赛中获得第二名。

结论

该技术简单有效。使用的套管可保护浅表神经,同时通过小的、美观的切口进行减压。

相似文献

本文引用的文献

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Compartment syndrome of the forearm: a systematic review.前臂骨筋膜室综合征:一项系统综述
J Hand Surg Am. 2011 Mar;36(3):535-43. doi: 10.1016/j.jhsa.2010.12.007.
8
Experimental study of forearm compartmental pressures.前臂筋膜间隔压力的实验研究
J Hand Surg Am. 2010 Oct;35(10):1620-5. doi: 10.1016/j.jhsa.2010.06.017. Epub 2010 Sep 16.

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