Fitze Guido, Strohm Peter C
Klinik und Poliklinik für Kinderchirurgie, Universitätsklinikum Carl Gustav Carus Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Klinik für Orthopädie und Unfallchirurgie, Sozialstiftung Bamberg, Bamberg, Deutschland.
Unfallchirurgie (Heidelb). 2025 Jun;128(6):410-416. doi: 10.1007/s00113-025-01553-2. Epub 2025 Mar 27.
Traumatic acute compartment syndrome in childhood is a rare complication following an accident but it occurs more frequently than generally assumed. The accident mechanisms and anatomical localization are very well known so that this complication must always be considered if these risk factors are present. The diagnostic confirmation is based on clinical examination findings and implies the assessment of the three A's: increasing anxiety, agitation and analgesic requirement. The measurement of compartment pressure can only be used if this examination is not possible or appears unsafe; however, there are no recognized age-adapted normal values. In the presence of manifest acute compartment syndrome, a timely dermatofasciotomy is the only treatment measure that results in a very good functional outcome. Otherwise, Volkmann's ischemic contracture cannot be avoided.
儿童创伤性急性骨筋膜室综合征是事故后的一种罕见并发症，但实际发生率比通常认为的要高。事故机制和解剖定位已为人熟知，因此如果存在这些危险因素，必须始终考虑到这种并发症。诊断的确立基于临床检查结果，需要评估三个“A”：焦虑加剧、躁动不安和镇痛需求增加。只有在无法进行或看似不安全的情况下，才使用骨筋膜室压力测量；然而，目前尚无公认的适合儿童的正常数值。一旦出现明显的急性骨筋膜室综合征，及时进行皮肤筋膜切开术是唯一能带来良好功能预后的治疗措施。否则，无法避免Volkmann缺血性挛缩。
