Morehouse School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA.
Philadelphia College of Osteopathic Medicine Georgia, Suwanee, GA, USA.
Am Surg. 2024 Aug;90(8):2107-2109. doi: 10.1177/00031348241241741. Epub 2024 Apr 3.
Compartment syndrome (CS) is a well-known surgical emergency with high morbidity including potential long-term disability and limb loss. The most important factor determining the degree of morbidity with CS is time to treatment; therefore, early diagnosis and surgery are vital. We present a patient who fell off his bicycle and sustained cervical spine fractures causing near complete quadriplegia. He was found by the road over 12 hours later, so his creatine phosphokinase (CPK) was trended and serial examinations were performed. We identified tight deltoid, trapezius, and latissimus compartments and brought him to the operating room for fasciotomies. Although lab values and compartment pressures can be helpful, they should not guide treatment. It is important to consider atypical sites for CS and complete a head to toe physical examination. Patients should proceed to the operating room if clinical suspicion exists for CS because of the morbidity associated with a missed diagnosis.
筋膜室综合征（CS）是一种众所周知的外科急症，发病率高，包括潜在的长期残疾和肢体丧失。决定 CS 发病率程度的最重要因素是治疗时间；因此，早期诊断和手术至关重要。我们介绍了一位患者，他从自行车上摔下来，导致颈椎骨折，近乎完全四肢瘫痪。他在 12 个多小时后被发现躺在路边，因此对他的肌酸磷酸激酶（CPK）进行了趋势分析，并进行了连续检查。我们发现三角肌、斜方肌和背阔肌筋膜室紧张，并将他带到手术室进行筋膜切开术。虽然实验室值和筋膜室压力可能有帮助，但它们不应指导治疗。重要的是要考虑 CS 的非典型部位，并进行从头到脚的全面体格检查。如果临床怀疑存在 CS，则应将患者送往手术室，因为漏诊会导致发病率增加。
