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一项关于已确诊腿部多室综合征患者并发症的观察性研究。

An observational study of complications in patients with established multiple compartments syndrome of the leg.

作者信息

Zibis Aristeidis, Varitimidis Sokratis, Fyllos Apostolos, Raoulis Vasilios, Karachalios Theophilos, Malizos Konstantinos

机构信息

Department of Anatomy, Faculty of Medicine, University of Thessaly, Larissa, Greece.

Department of Orthopaedics and Musculoskeletal Trauma, Faculty of Medicine, University of Thessaly, Larisa, Greece.

出版信息

Arch Orthop Trauma Surg. 2021 Feb;141(2):253-259. doi: 10.1007/s00402-020-03488-2. Epub 2020 May 30.

Abstract

INTRODUCTION

Established multiple compartments syndrome of the leg (EMCSL) is defined as permanent ischemic lesions of muscles and nerves of the compartment, leading to multiple muscle contractions, muscle weakness and wasting and reduced limb sensation. The leg is seriously affected and the patient is unable to return to prior activities. The objective of this research is to quantify long-term consequences, morbidity and socioeconomic impact of established multiple compartments syndrome of the leg MATERIALS AND METHODS: 28 patients suffering from complications from EMCSL were referred to our clinic for secondary management between January 2012 and April 2016 and were followed for mean 41.4 months. Reconstructive procedures to address multiple conditions following established tibia compartment syndrome were performed. The number of reconstructive procedures, days of hospitalization, relationship, educational and employment status per patient were recorded. Preop and postop SF-12 score at final follow-up was documented for the 21 patients who were operated on.

RESULTS

A median of three reconstructive procedures was performed per patient for 21 patients. The hospitalization period ranged from 6 to 365 days, with a mean period of 47.5 days (SD 71.4). At the final follow-up, 19 patients had lost their occupation, 3 patients had returned to lighter manual labor, 5 patients had lost two school years, and 1 patient had abandoned school. At the time of injury, 24 patients were single. At final follow-up, 19 of these patients, with a mean age of 38.5 years, were still single. Preoperative and postoperative (at final follow-up) physical and mental components of the SF-12 score had a statistically significant difference (p < 0.001), but final values were not normal.

CONCLUSIONS

Despite advancements in surgical reconstructive intervention, patients with established compartment tibia syndrome experience permanent grave residual disability with personal and social implications.

摘要

引言

已确诊的小腿多室综合征(EMCSL)被定义为肌室的肌肉和神经出现永久性缺血性损伤,导致多处肌肉挛缩、肌肉无力和萎缩以及肢体感觉减退。小腿受到严重影响,患者无法恢复到之前的活动状态。本研究的目的是量化已确诊的小腿多室综合征的长期后果、发病率和社会经济影响。

材料与方法

2012年1月至2016年4月期间,28例患有EMCSL并发症的患者被转诊至我院进行二次治疗,并平均随访41.4个月。针对已确诊的胫骨肌室综合征后的多种情况进行了重建手术。记录了每位患者的重建手术次数、住院天数、人际关系、教育和就业状况。对21例接受手术的患者记录了术前和最终随访时的SF-12评分。

结果

21例患者每人平均进行了3次重建手术。住院时间为6至365天,平均47.5天(标准差71.4)。在最终随访时,19例患者失去了工作,3例患者恢复了较轻的体力劳动,5例患者耽误了两个学年,1例患者辍学。受伤时,24例患者为单身。在最终随访时,这些患者中有19例,平均年龄38.5岁,仍然单身。SF-12评分的术前和术后(最终随访时)身体和心理成分有统计学显著差异(p<0.001)但最终值不正常。

结论

尽管手术重建干预有所进展,但已确诊的胫骨肌室综合征患者仍会经历严重的永久性残余残疾,并对个人和社会产生影响。

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