Phan Man Duc Minh, Nguyen Ly Thi Thanh, Nguyen Tien Minh, Nguyen Phi Duong
Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam.
City Children's Hospital, Ho Chi Minh City, Viet Nam.
Trauma Case Rep. 2024 Jun 10;52:101071. doi: 10.1016/j.tcr.2024.101071. eCollection 2024 Aug.
This case report presents the clinical course and management of a 29-day-old female infant who presented with upper limb trauma secondary to entrapment beneath a sewing machine. Following admission, the patient exhibited clinical signs consistent with arterial injury and compartment syndrome, necessitating prompt diagnostic evaluation and surgical intervention. Despite challenges in arterial visualization via Doppler ultrasound, radiographic imaging confirmed displaced distal humerus fracture of the left upper limb, prompting further evaluation and surgical planning. Surgical decompression and stabilization were performed, followed by successful endovascular intervention utilizing digital subtraction angiography (DSA) to restore arterial perfusion. Subsequent development of compartment syndrome necessitated emergent fasciotomy, followed by wound care and skin grafting. Multidisciplinary rehabilitation facilitated optimal recovery, with the patient demonstrating improved motor function and sensory perception at six-month follow-up. This case underscores the importance of timely recognition, multidisciplinary collaboration, and prompt intervention in managing pediatric upper limb trauma complicated by arterial injury and compartment syndrome.
本病例报告介绍了一名29天大的女婴的临床病程及治疗情况,该女婴因被缝纫机夹住而出现上肢创伤。入院后,患者表现出与动脉损伤和骨筋膜室综合征相符的临床体征,需要进行迅速的诊断评估和手术干预。尽管通过多普勒超声进行动脉可视化存在挑战,但影像学检查证实左上肢肱骨远端骨折移位,促使进一步评估和手术规划。进行了手术减压和固定,随后利用数字减影血管造影(DSA)成功进行血管内介入以恢复动脉灌注。随后出现的骨筋膜室综合征需要紧急进行筋膜切开术,之后进行伤口护理和皮肤移植。多学科康复促进了最佳恢复,患者在六个月随访时运动功能和感觉知觉有所改善。本病例强调了在处理合并动脉损伤和骨筋膜室综合征的小儿上肢创伤时及时识别、多学科协作和迅速干预的重要性。