Kudo Yuki, Maeyama Akira, Hara Masafumi, Yamamoto Takuaki
Department of Orthopaedic Surgery Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 810-0180, Japan.
Department of Orthopaedic Surgery, Hisatsune Hospital, 152-1 Aza Ushimaru, Oaza Tasomi, Shime-machi, Kasuya, Fukuoka, 811-2204, Japan.
J Orthop Case Rep. 2022 Feb;12(2):45-48. doi: 10.13107/jocr.2022.v12.i02.2660.
Acute compartment syndrome (ACS) is one of the most serious orthopedic diseases causing complications and requiring emergency surgery. Most cases of ACS are associated with fractures and crush injuries. However, surgical procedures can also cause ACS.
We herein describe a 41-year-old man who underwent arthroscopic surgery for revision anterior cruciate ligament reconstruction with the semitendinosus tendon. Two days after the operation, the patient developed ACS of the left lower leg. This patient had undergone anterior cruciate ligament(ACL) reconstruction previously, and we assumed that the cause of the ACS was damage to the small blood vessels from the collateral circulation during hamstring tendon harvesting. Fasciotomy was performed under general anesthesia, and his postoperative course was uneventful.
ACS after revision anterior cruciate ligament reconstruction is rare. We should keep in mind that patients who have undergone previous surgery may develop ACS due to damage to the collateral circulation. To avoid ACS, harvesting tendon from the healthy side can avoid damage to the collateral circulation.
急性骨筋膜室综合征（ACS）是最严重的骨科疾病之一，可导致并发症并需要急诊手术。大多数ACS病例与骨折和挤压伤有关。然而，外科手术也可引发ACS。
我们在此描述一名41岁男性，他接受了关节镜手术，用半腱肌进行前交叉韧带翻修重建。术后两天，患者出现左小腿急性骨筋膜室综合征。该患者此前曾接受过前交叉韧带（ACL）重建，我们推测急性骨筋膜室综合征的病因是在取腘绳肌腱时侧支循环的小血管受损。在全身麻醉下进行了筋膜切开术，术后恢复顺利。
前交叉韧带翻修重建术后发生急性骨筋膜室综合征较为罕见。我们应牢记，既往接受过手术的患者可能因侧支循环受损而发生急性骨筋膜室综合征。为避免急性骨筋膜室综合征，从健康侧取腱可避免侧支循环受损。
