Alahmadi Dinah F, Halawani Ibrahim R, Alghamdi Abdulaziz M, Shawosh Mohammed H, Althobaity Adil N
Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU.
Medicine, King Abdulaziz University, Jeddah, SAU.
Cureus. 2024 Aug 30;16(8):e68177. doi: 10.7759/cureus.68177. eCollection 2024 Aug.
Mandibulectomy with free fibular flap reconstruction is a well-established procedure in head and neck surgery, recognized for its functional and aesthetic outcomes. However, this procedure carries certain risks, including the rare occurrence of late-onset donor site morbidities such as compartment syndrome. We report the case of a 67-year-old male with multiple comorbidities who developed compartment syndrome due to delayed hematoma formation at the donor site after undergoing segmental mandibulectomy with left fibular osteocutaneous free flap reconstruction. The patient, who was on antithrombotic therapy for ischemic heart disease, presented with severe calf pain and swelling on the 11th postoperative day, necessitating urgent surgical intervention. Hematoma evacuation and meticulous hemostasis led to a successful outcome. This case underscores the importance of thorough preoperative evaluation, precise surgical technique, and vigilant postoperative monitoring, especially in patients with significant comorbidities. Prompt recognition and management of delayed hematoma are essential to prevent further complications. Enhanced awareness and early intervention are critical in addressing this rare complication, and further research is warranted to establish standardized guidelines and identify specific risk factors for delayed hematoma formation.
游离腓骨瓣重建下颌骨切除术是头颈外科中一种成熟的手术方法，因其功能和美学效果而得到认可。然而，该手术存在一定风险，包括罕见的迟发性供区并发症，如骨筋膜室综合征。我们报告了一例67岁男性患者，该患者有多种合并症，在接受左侧游离腓骨骨皮瓣重建节段性下颌骨切除术后，因供区血肿形成延迟而发生骨筋膜室综合征。该患者因缺血性心脏病正在接受抗血栓治疗，术后第11天出现严重的小腿疼痛和肿胀，需要紧急手术干预。血肿清除和细致止血取得了成功的结果。该病例强调了全面术前评估、精确手术技术和术后密切监测的重要性，尤其是在有严重合并症的患者中。及时识别和处理延迟性血肿对于预防进一步并发症至关重要。提高认识和早期干预对于解决这种罕见并发症至关重要，有必要进一步研究以建立标准化指南并确定延迟性血肿形成的特定风险因素。
