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一名使用口服抗凝剂的患者在采用前路进行髋关节置换术后出现大腿急性骨筋膜室综合征。

Acute compartment syndrome of the thigh following hip replacement by anterior approach in a patient using oral anticoagulants.

作者信息

Hogerzeil Dirk Pieter, Muradin Imraan, Zwitser Eline W, Jansen Joris A

机构信息

Department of Orthopedic Surgery, Alrijne Hospital, Leiderdorp, GA 2353, The Netherlands.

出版信息

World J Orthop. 2017 Dec 18;8(12):964-967. doi: 10.5312/wjo.v8.i12.964.

DOI:10.5312/wjo.v8.i12.964
PMID:29312856
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5745440/
Abstract

Acute compartment syndrome (ACS) of the thigh following primary total hip arthroplasty (THA) is a highly uncommon complication and has not yet been reported before with regards to the anterior approach through the anterior supine interval. We present a case of a 69-year-old male patient with a history of stroke, who developed ACS of the thigh after elective THA while using therapeutic low molecular weight heparin as bridging for regular oral anticoagulation. ACS pathogenesis, diagnostic tools, treatment and relevant literature are discussed. The patient's ACS was recognized in time and treated by operative decompression with fasciotomy of the anterior compartment. Follow-up did not show any neurological deficit or soft-tissue damage.

摘要

初次全髋关节置换术(THA)后发生大腿急性骨筋膜室综合征(ACS)是一种极为罕见的并发症,且此前尚无关于经仰卧位前间隙的前路手术引发该综合征的报道。我们报告一例69岁男性卒中患者,在择期THA术后使用治疗性低分子量肝素作为常规口服抗凝的桥接治疗时发生了大腿ACS。文中讨论了ACS的发病机制、诊断工具、治疗方法及相关文献。该患者的ACS得到及时诊断,并通过前路骨筋膜室切开减压术进行治疗。随访未发现任何神经功能缺损或软组织损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e63e/5745440/5386fab7d26b/WJO-8-964-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e63e/5745440/9b575f6efefd/WJO-8-964-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e63e/5745440/45d49cb7fda9/WJO-8-964-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e63e/5745440/8efbdfdccdfe/WJO-8-964-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e63e/5745440/5386fab7d26b/WJO-8-964-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e63e/5745440/9b575f6efefd/WJO-8-964-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e63e/5745440/45d49cb7fda9/WJO-8-964-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e63e/5745440/8efbdfdccdfe/WJO-8-964-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e63e/5745440/5386fab7d26b/WJO-8-964-g004.jpg

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本文引用的文献

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Ortop Traumatol Rehabil. 2013 Jun 28;15(3):269-71. doi: 10.5604/15093492.1058422.
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Compartment syndrome of the thigh. A case report with delayed onset after stable pelvic ring fracture and chronic anticoagulation therapy.股部间隔综合征。一例稳定骨盆环骨折和慢性抗凝治疗后迟发性病例报告。
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膝下截肢术后骨筋膜室综合征
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Acute compartment syndrome of the thigh after joint replacement with anticoagulation.关节置换术后抗凝治疗导致的大腿急性骨筋膜室综合征
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