Choi Jun Ho, Choi Seung Yeon, Hwang Jae Ha, Kim Kwang Seog, Lee Sam Yong
Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital Chonnam National University Medical School, Gwangju 61469, South Korea.
World J Clin Cases. 2023 May 6;11(13):3017-3021. doi: 10.12998/wjcc.v11.i13.3017.
Although the finger compartment syndrome is not common, it compresses the neurovascular bundles in a limited space and blocks blood flow to the fingers, causing necrosis of the fingertips. Finger fasciotomy through unilateral or bilateral midline release of the finger can achieve decompression of the finger compartment. Herein, we report a case of the compartment syndrome in a finger injury caused by a high-pressure water flow which is commonly used in car washing stations.
A 60-year-old man injured his right middle finger while using a high-pressure washer at a car washing station. The patient complained of severe pain in his middle finger and a 0.2 cm punctured open wound on the volar side of the distal phalangeal joint of the middle finger. The fingertip was pale, numb, and characterized by severe swelling and a limited range of motion. Finger radiography showed that there was no fracture in the finger. Digital decompression was performed through finger fasciotomy by bilateral midline incision. On the second day after surgery, the color of the fingertip returned to pink, swelling was resolved, and the range of motion returned to normal. The sensation of the fingertip was completely restored, and the capillary refill test and pinprick test were positive.
The fingertip compartment syndrome can be caused by a high-pressure water flow damage to the fingers when using high-pressure washers at a car washing station. To avoid finger necrosis, rapid diagnosis of the finger compartment syndrome and appropriate digital decompression are essential to better outcome.
尽管手指骨筋膜室综合征并不常见,但它在有限空间内压迫神经血管束,阻碍手指血液流动,导致指尖坏死。通过单侧或双侧手指中线切开进行手指筋膜切开术可实现手指骨筋膜室减压。在此,我们报告一例因洗车场常用的高压水流导致手指损伤引发的骨筋膜室综合征病例。
一名60岁男性在洗车场使用高压清洗机时右手中指受伤。患者主诉中指剧痛,中指远节指骨掌侧关节处有一个0.2厘米的穿刺开放性伤口。指尖苍白、麻木,肿胀严重,活动范围受限。手指X线检查显示手指无骨折。通过双侧中线切口行手指筋膜切开术进行手指减压。术后第二天,指尖颜色恢复红润,肿胀消退,活动范围恢复正常。指尖感觉完全恢复,毛细血管再充盈试验和针刺试验均为阳性。
在洗车场使用高压清洗机时,高压水流对手指的损伤可导致指尖骨筋膜室综合征。为避免手指坏死,快速诊断手指骨筋膜室综合征并进行适当的手指减压对于获得更好的治疗效果至关重要。