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术中骨盆固定带复位开放性骨盆骨折后双侧大腿间隔综合征:病例报告及文献复习。

Bilateral thigh compartment syndrome following intraoperative pelvic binder reduction of open pelvic fracture: a case report and review of literature.

机构信息

Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, 1520 San Pablo Street, Suite 2000, Los Angeles, CA, 90033-5322, USA.

Queen's University Medical Group, 1301 Punchbowl Street, Honolulu, HI, 96813, USA.

出版信息

Eur J Orthop Surg Traumatol. 2024 Dec;34(8):4133-4138. doi: 10.1007/s00590-024-04090-7. Epub 2024 Sep 6.

Abstract

CASE

A 22-year-old man with a type IIIA open AO/OTA 61C2.2b pelvis fracture and hypotension received exploratory laparotomy, temporary open ligation of the bilateral internal iliac arteries, and retroperitoneal packing. After prompt fracture debridement, a pelvic binder was positioned over the thighs as a reduction aid and maintained for six hours during pelvis open reduction internal fixation. Bilateral anterior thigh compartment syndrome was diagnosed three hours after packing and binder removal.

CONCLUSION

Prolonged application of a pelvic binder to the thighs as an intraoperative reduction tool, shortly after temporary internal iliac artery ligation, may be associated with reperfusion injury and thigh compartment syndrome.

摘要

病例

一名 22 岁男子患有 IIIA 型开放性 AO/OTA 61C2.2b 骨盆骨折和低血压,接受了剖腹探查术、双侧髂内动脉临时开放性结扎和腹膜后填塞。迅速进行骨折清创后,在大腿上放置骨盆固定带作为复位辅助工具,并在骨盆切开复位内固定期间保持 6 小时。填塞和固定带去除后 3 小时诊断为双侧股前间室综合征。

结论

在临时髂内动脉结扎后不久,将骨盆固定带长时间应用于大腿作为术中复位工具,可能与再灌注损伤和股间室综合征有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e78/11519102/c97856cc7615/590_2024_4090_Fig1_HTML.jpg

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