Turen C H, Burgess A R, Vanco B
Division of Orthopaedic Traumatology, R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore 21201-1593, USA.
Clin Orthop Relat Res. 1995 Jun(315):163-8.
To determine the possible relationship between outcome and fixation method for tibial fractures associated with compartment syndrome, the authors retrospectively reviewed the records of 96 patients (average age, 31.8 years) with this injury. Seventy-eight patients had multiple injuries (average Injury Severity Score, 22.37). There were 68 closed and 28 open fractures, including 3 gunshot wounds. Compartment syndrome was diagnosed by direct measurement or by clinical findings. The attending surgeon selected the type of fixation based on fracture pattern and associated injuries. Time to healing for the 96 fractures averaged 31.6 weeks. There was no significant difference in healing times between open and closed fractures or between methods of treatment. Healing time for closed fractures was significantly different from that reported for closed fractures not associated with compartment syndrome (30.2 compared with 17.3 weeks, respectively; open fracture healing times were not significantly different (35 compared with 29.3 weeks, respectively). The authors conclude that (1) compartment syndrome significantly lengthens the time to healing for closed tibial fractures but does not significantly affect the time to healing for open tibial fractures; (2) closed tibial fractures with compartment syndrome appear to act as open fractures; and (3) the method of fixation does not appear to affect time to healing for closed or open fractures associated with compartment syndrome.
为确定伴有骨筋膜室综合征的胫骨骨折的治疗结果与固定方法之间可能存在的关系，作者回顾性分析了96例此类损伤患者（平均年龄31.8岁）的病历。78例患者有多处损伤（平均损伤严重度评分22.37）。有68例闭合性骨折和28例开放性骨折，其中包括3例枪伤。骨筋膜室综合征通过直接测量或临床表现来诊断。主刀医生根据骨折类型和相关损伤选择固定方式。96处骨折的平均愈合时间为31.6周。开放性骨折与闭合性骨折之间或不同治疗方法之间的愈合时间无显著差异。伴有骨筋膜室综合征的闭合性骨折的愈合时间与不伴有骨筋膜室综合征的闭合性骨折的愈合时间有显著差异（分别为30.2周和17.3周；开放性骨折的愈合时间无显著差异，分别为35周和29.3周）。作者得出结论：（1）骨筋膜室综合征显著延长了闭合性胫骨骨折的愈合时间，但对开放性胫骨骨折的愈合时间无显著影响；（2）伴有骨筋膜室综合征的闭合性胫骨骨折似乎表现为开放性骨折；（3）固定方法似乎不影响伴有骨筋膜室综合征的闭合性或开放性骨折的愈合时间。
