Moehring H D, Voigtlander J P
Department of Orthopedics, University of California, Davis, Medical Center, Sacramento 95817, USA.
Orthopedics. 1995 Jul;18(7):631-5; discussion 635-6. doi: 10.3928/0147-7447-19950701-09.
Twenty-six legs in 25 patients were monitored prospectively for compartment pressures during intramedullary nailing of open and closed tibial shaft fractures. Twenty-three patients were treated within 24 hours of admission. Twenty-three unreamed and three reamed intramedullary rods were utilized. Compartment pressures were measured initially, following fracture reduction, and during reaming. Pressures were also measured at the completion of nailing with the ankle dorsiflexed and at rest (plantar flexed) to determine positional effects on compartment pressures. Nine fractures (35%) were found to have persistently elevated pressures (> 40 mm Hg) and underwent immediate four-compartment fasciotomy. The remaining group of 17 fractures (65%) was monitored throughout the intraoperative period. No patient monitored intraoperatively developed postoperative compartment syndrome.
对25例患者的26条腿进行前瞻性监测，以测量开放性和闭合性胫骨干骨折髓内钉固定期间的骨筋膜室压力。23例患者在入院后24小时内接受治疗。使用了23根未扩髓和3根扩髓的髓内钉。分别在初始时、骨折复位后以及扩髓期间测量骨筋膜室压力。在髓内钉固定完成时，使踝关节背屈及处于休息位（跖屈）时也测量压力，以确定体位对骨筋膜室压力的影响。发现9例骨折（35%）骨筋膜室压力持续升高（>40 mmHg），并立即进行了四室筋膜切开术。其余17例骨折（65%）在整个手术过程中进行监测。术中接受监测的患者均未发生术后骨筋膜室综合征。
