Department of Orthopaedics, University of British Columbia, 3rd Floor, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada.
Department of Orthopaedics, University of British Columbia, 3rd Floor, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada.
Orthop Clin North Am. 2022 Jan;53(1):25-32. doi: 10.1016/j.ocl.2021.08.002. Epub 2021 Oct 28.
Early diagnosis and prompt definitive management of acute compartment syndrome (ACS) are paramount in preventing the significant morbidity associated with compartment syndrome. The diagnosis of compartment syndrome can be difficult, given the pain associated with the procedure in the immediate postoperative period. Obesity, anticoagulation, postoperative epidural infusion, and prolonged operative time have been reported as risk factors for ACS. In addition to maintaining high clinical suspicion in patient with risk factors for ACS after joint replacement, emphasis on limiting modifiable risk factors should be practiced, including meticulous hemostasis, careful patient positioning, and limiting prolonged postoperative regional anesthesia when not required.
早期诊断和及时明确急性间隔综合征(ACS)的处理至关重要,可以预防与间隔综合征相关的显著发病率。由于术后即刻与该操作相关的疼痛,ACS 的诊断可能具有挑战性。肥胖、抗凝、术后硬膜外输注和手术时间延长已被报道为 ACS 的危险因素。除了在关节置换后具有 ACS 危险因素的患者中保持高度临床怀疑外,还应强调限制可改变的危险因素,包括精细止血、仔细患者体位以及在不需要时限制长时间的术后区域麻醉。