Al Nasser Abdulrhman M, Harvey Edward J, Bunting Alexandra C
Surgery, McGill University, Montreal, CAN.
Cureus. 2024 Nov 25;16(11):e74453. doi: 10.7759/cureus.74453. eCollection 2024 Nov.
Compartment syndrome (CS) arises from various etiologies but is most commonly associated with severe traumatic injuries. It is a difficult diagnosis to make in a timely fashion because clinical signs and symptoms are subjective. Missing the diagnosis is a devastating mistake for the patient and the physician. There has been protracted debate over the effectiveness of clinical signs and symptoms, particularly concerns over their sensitivity and specificity. Both missed diagnoses and unneeded prophylactic releases are costly to the health system. A desired device would be an objective tool that decreased false positives and negatives while ensuring diagnosis in a timely fashion of true positives. The treatment for CS is immediate fasciotomy, but fasciotomy is not a complication-free procedure. Physicians need to be sure of the diagnosis both in order not to have the devastating consequence of a missed case but also not to perform with prophylactic fasciotomies that add to patient complications and the cost of treatment. Previous care maps usually resulted in fasciotomy being performed in extremities that will not or have not yet developed CS. New technology that allows monitoring of continuous pressure monitoring seems to currently be the best aid to diagnosis. We present our experience in using continuous pressure monitoring in decreasing time to diagnosis in a case post-trauma of a lower limb with minimal pain.
骨筋膜室综合征（CS）由多种病因引起，但最常见于严重创伤性损伤。由于临床体征和症状具有主观性，所以很难及时做出诊断。漏诊对患者和医生来说都是一个毁灭性的错误。关于临床体征和症状的有效性一直存在长期争论，尤其是对其敏感性和特异性的担忧。漏诊和不必要的预防性切开减压术对卫生系统来说成本都很高。理想的设备应该是一种客观工具，既能减少假阳性和假阴性，又能确保及时诊断出真正的阳性病例。CS的治疗方法是立即进行筋膜切开术，但筋膜切开术并非没有并发症。医生必须确定诊断，以免漏诊导致毁灭性后果，同时也避免进行预防性筋膜切开术，因为这会增加患者的并发症和治疗成本。以前的护理方案通常会导致在尚未或不会发生CS的肢体上进行筋膜切开术。目前，能够进行连续压力监测的新技术似乎是诊断的最佳辅助手段。我们介绍了在一例下肢创伤后疼痛轻微的病例中，使用连续压力监测来缩短诊断时间的经验。
