Peterson T, Dresing K, Schmidt G
Abteilung für Unfallchirurgie, Medizinische Einrichtungen der Universität, GHS, Essen.
Unfallchirurg. 1993 Apr;96(4):217-23.
During to the nature of its anatomical locations the median nerve is the nerve most often and most severely affected in compartment syndromes. In our controlled prospective study of 59 patients with distal fractures of the radius, critically high pressure was recorded in the carpal tunnel even in sites of moderate soft tissue swelling. The increase in pressure is directly related to the extent of fracture hematoma, the interval between injury and treatment, and the amount of manipulation during reduction. The average pressure within the carpal tunnel of a normal wrist joint held in the neutral position is 5 mm Hg. In contrast, the average carpal tunnel pressure in the distal radius fracture group in this study was increased to 24 mmHg. During reduction average pressures increase to 44 mmHg, subsequently decrease for a brief period, and finally increase to 34 mmHg 4 h later. At 12 h after reduction average values are still 26 mm Hg. Patients developing Sudeck's dystrophy during treatment (n = 4) exhibit above-average carpal tunnel pressure.
由于其解剖位置的特点，正中神经是骨筋膜室综合征中最常且最易受严重影响的神经。在我们对59例桡骨远端骨折患者进行的对照前瞻性研究中，即使在软组织轻度肿胀的部位，腕管内也记录到了极高的压力。压力升高与骨折血肿的范围、受伤与治疗之间的间隔以及复位过程中的手法操作量直接相关。正常中立位腕关节腕管内的平均压力为5 mmHg。相比之下，本研究中桡骨远端骨折组的腕管平均压力增至24 mmHg。复位过程中平均压力增至44 mmHg，随后短时间下降，最终在4小时后又增至34 mmHg。复位后12小时的平均值仍为26 mmHg。治疗期间发生苏戴克氏营养不良的患者（n = 4）表现出高于平均水平的腕管压力。
