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无骨折血肿导致幼儿急性前臂骨筋膜室综合征:一例报告

Acute Forearm Compartment Syndrome in a Toddler Caused by Hematoma without Fracture: A Case Report.

作者信息

Naganuma Yasushi, Satake Hiroshi, Fukuda Norio, Takagi Michiaki

机构信息

Department of Orthopedic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.

Department of Orthopedic Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan.

出版信息

J Orthop Case Rep. 2025 Sep;15(9):121-124. doi: 10.13107/jocr.2025.v15.i09.6038.

Abstract

INTRODUCTION

Acute forearm compartment syndrome (AFCS) is rare in pediatric patients. Diagnosis of AFCS in pediatric patients is often difficult based on their presentation variability and immature verbal. We present a case of AFCS in a toddler who showed specific congestion from the distal forearm to the hand that resulted in a hematoma without fracture.

CASE REPORT

A 2-year-old boy had right upper extremity pain and paralysis after falling from a chair. He had no family history of congenital hemorrhagic diseases or anticoagulant medications. His right distal forearm to hand was congested with a clear borderline to the proximal forearm. It was unable to detect any fractures in the X-rays. We diagnosed him with AFCS and performed a fasciotomy that showed a developing hematoma around the carpal tunnel. Two years after surgery, he had no signs of neurological defect in the upper extremity.

CONCLUSION

The toddler was injured by a low-energy fall, which was atypical enough to suggest the onset of ACFS. Congestion beyond the wrist, with a clear border to the proximal area, indicating peripheral circulatory disturbance, was the most notable physical finding in this case.

摘要

引言

急性前臂骨筋膜室综合征(AFCS)在儿科患者中较为罕见。由于儿科患者临床表现的多样性以及语言表达不成熟,AFCS的诊断往往具有挑战性。我们报告一例幼儿AFCS病例,该患儿表现为从远端前臂到手部的特定充血,并导致血肿形成,但无骨折。

病例报告

一名2岁男孩从椅子上摔落后出现右上肢疼痛和麻痹。他没有先天性出血性疾病家族史或服用抗凝药物。其右前臂远端到手部充血,与近端前臂界限清晰。X线检查未发现任何骨折。我们诊断他为AFCS,并进行了筋膜切开术,术中发现腕管周围有逐渐形成的血肿。术后两年,他上肢无神经功能缺损迹象。

结论

该幼儿因低能量跌倒受伤,这种情况非典型,足以提示急性骨筋膜室综合征的发病。腕部以外的充血,与近端区域界限清晰,提示外周循环障碍,是该病例最显著的体格检查发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58ab/12422649/88bf59079c17/JOCR-15-121-g001.jpg

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