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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.

DOI:10.1007/s00590-024-04090-7
PMID:39240350
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11519102/
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/f70a1255ac09/590_2024_4090_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e78/11519102/c97856cc7615/590_2024_4090_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e78/11519102/f70a1255ac09/590_2024_4090_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e78/11519102/c97856cc7615/590_2024_4090_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e78/11519102/f70a1255ac09/590_2024_4090_Fig2_HTML.jpg

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本文引用的文献

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J Am Acad Orthop Surg. 2024 Feb 15;32(4):e166-e174. doi: 10.5435/JAAOS-D-23-00734. Epub 2023 Dec 13.
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Standard practice in the treatment of unstable pelvic ring injuries: an international survey.不稳定骨盆环损伤治疗的标准实践：一项国际调查。
Int Orthop. 2023 Sep;47(9):2301-2318. doi: 10.1007/s00264-023-05859-x. Epub 2023 Jun 17.
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Pelvic Ring Injury Mortality: Are We Getting Better?
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J Orthop Trauma. 2022 Feb 1;36(2):81-86. doi: 10.1097/BOT.0000000000002210.
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Risk factors for complications and in-hospital mortality: An analysis of 19,834 open pelvic ring fractures.并发症及院内死亡率的危险因素：对19834例开放性骨盆环骨折的分析
J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1110-1116. doi: 10.1016/j.jcot.2020.08.017. Epub 2020 Aug 25.
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Time to definitive fixation of pelvic and acetabular fractures.骨盆和髋臼骨折确定性固定的时机。
J Trauma Acute Care Surg. 2020 Oct;89(4):730-735. doi: 10.1097/TA.0000000000002860.
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