Unit of Human Anatomy and Embryology, University of Barcelona, C/Feixa Llarga s/n 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
Basic Sciences Department, Universitat Internacional de Catalunya, Barcelona, Spain.
Surg Radiol Anat. 2021 Oct;43(10):1569-1579. doi: 10.1007/s00276-021-02736-3. Epub 2021 Apr 5.
Acute compartment syndrome is defined as a limb-threatening condition caused by bleeding or oedema in a closed muscle compartment surrounded by fascia or bone. It is most commonly encountered in the forearm, which has three compartments: posterior, anterior and lateral. These are surrounded and closed in by the antebrachial fascia, formed by dense connective tissue that facilities their study on ultrasound and is key to fasciotomy treatment. The purpose of this study was to broaden existing ultrasound, anatomical and histological knowledge of the fascia of the forearm to facilitate their identification on ultrasound, with possible clinical and therapeutic applications.
The study was performed in 50 cryopreserved upper limbs from adult cadavers from the dissection room of the Faculty of Medicine and Health Sciences. They were examined on ultrasound and subsequent anatomical dissection and microscopy to study the fascia and its relationship with different muscles of the forearm compartments.
Distinct anatomical relationships were observed on ultrasound and dissection between the fascia and the extensor carpi ulnaris, extensor digiti minimi, and anconeus muscle in the posterior compartment, and the flexor carpi radialis and flexor carpi ulnaris in the anterior compartment. They were isolated by the antebrachial fascia and had distinct relationships with the neurovascular structures.
These results demonstrate that high-definition ultrasound enables us to locate the antebrachial fascia and particular muscles with a distinct relationship with neurovascular structures. This helps better identify these structures, facilitating diagnosis of any pathology in the area, with potential therapeutic and clinical applications.
急性间隔综合征是一种由封闭的筋膜或骨周围肌肉间隙内出血或水肿引起的危及肢体的疾病。它最常见于前臂，前臂有三个间隔：后、前和外侧。这些间隔由前臂筋膜围绕和封闭，前臂筋膜由致密结缔组织形成，便于在超声上进行研究，是筋膜切开术治疗的关键。本研究的目的是拓宽现有的关于前臂筋膜的超声、解剖和组织学知识，以便在超声上更容易识别，可能具有临床和治疗应用价值。
本研究在来自医学与健康科学系解剖室的 50 个冷冻保存的成人上肢标本上进行。对其进行超声检查，然后进行解剖和显微镜检查，以研究筋膜及其与前臂间隔不同肌肉的关系。
在超声和解剖中观察到，在后间隔中，筋膜与尺侧腕伸肌、小指伸肌和肘肌之间存在明显的解剖关系，在前间隔中，筋膜与桡侧腕屈肌和尺侧腕屈肌之间存在明显的解剖关系。它们被前臂筋膜隔开，与神经血管结构有明显的关系。
这些结果表明，高清晰度超声能够定位前臂筋膜和特定的肌肉，与神经血管结构有明显的关系。这有助于更好地识别这些结构，便于诊断该区域的任何病理，具有潜在的治疗和临床应用价值。
