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一拳之后:轻微创伤后骨筋膜室综合征复发

After a punch: recurrence of compartment syndrome following minor trauma.

作者信息

Ryndin Stanislav, Delozier Andrew, Stanley Michael

机构信息

Department of General Medical Education-Transitional Year Resident, Kaweah Delta Health Care District, Visalia, CA 93291, USA.

Department of Emergency Medicine, Kaweah Delta Health Care District, Visalia, CA 93291, USA.

出版信息

J Surg Case Rep. 2018 Feb 7;2018(2):rjy011. doi: 10.1093/jscr/rjy011. eCollection 2018 Feb.

Abstract

Acute compartment syndrome (ACS) is a diagnosis that requires high-clinical suspicion especially in cases when the initial causal event could be considered insignificant. We present a novel case presentation of ACS associated with minor trauma in a patient with a previous history of compartment syndrome in the same extremity from a motor vehicle accident 10 years prior to presentation. To the best of our knowledge, this is the first reported case of recurrent ACS. Due to the possibility of significant morbidity, including loss of limb, it is imperative to recognize the presentation quickly so proper surgical intervention can occur. This case shows compartment syndrome can occur after a low impact mechanism of injury and previous compartment syndrome may be a risk factor, lowering the threshold for a re-occurrence. Serial exams and compartment pressure measurements should be used to aid recognition in ambiguous clinical presentations.

摘要

急性骨筋膜室综合征(ACS)是一种需要高度临床怀疑的诊断,尤其是在初始病因事件可能被认为不严重的情况下。我们报告了一例与轻微创伤相关的急性骨筋膜室综合征的新病例,该患者在此次就诊前10年曾因机动车事故在同一肢体发生过骨筋膜室综合征。据我们所知,这是首例复发性急性骨筋膜室综合征的报道病例。由于存在包括肢体丧失在内的严重发病可能性,必须迅速识别其临床表现,以便能够进行适当的手术干预。该病例表明,低冲击力损伤机制后可发生骨筋膜室综合征,既往骨筋膜室综合征可能是一个危险因素,会降低复发阈值。对于临床表现不明确的情况,应采用系列检查和骨筋膜室内压力测量来辅助诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e666/5801601/50968e072fa8/rjy011f01.jpg

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