Kouvalchouk J F, Watin Augouard L, Dufour O, Coudert X, Paszkowski A
Service de Chirurgie Orthopédique et Traumatologie du Sport, Suresnes.
Rev Chir Orthop Reparatrice Appar Mot. 1993;79(5):351-6.
The chronic anterior compartment syndrome of the forearm is a rare pathology (3 cases have been already published), and of new knowledge. Three new cases on 2 patients (one on both sides) are described here. The authors describe recent advances about physiopathology, exploration and surgical treatment. It is due to strenuous activity using flexor muscles of the forearm without any release period (here motor cyclist competition). The symptom was pain at the anterior forearm similar to cramp. The most important for diagnosis was to measure the pressure after activity. The threshold level read after activity was up to 30 mm of Hg, with a very slow coming back to normal value. The isotopic scanner with hydroxyl methylene di-phosphonate (HMDP), after activity, showed a delay of arrival of the tracer and a stasis. RMI seems to give abnormal modification of the signal. The only treatment was surgical and an open fasciotomy of superficial and deep fascia must be done, with opening of the muscle's perimysium. The patients became painfree and resumed their sport after surgical treatment.
前臂慢性骨筋膜室综合征是一种罕见的病症(此前仅发表过3例病例报告),且相关知识尚新。本文描述了2例患者(其中1例双侧患病)的3个新病例。作者阐述了该病在病理生理学、检查及外科治疗方面的最新进展。该病是由于前臂屈肌持续剧烈活动且无任何放松期(如摩托车比赛)所致。症状为前臂前部疼痛,类似抽筋。诊断的关键在于活动后测量压力。活动后测得的阈值高达30毫米汞柱,且恢复至正常值的过程非常缓慢。活动后使用羟基亚甲基二膦酸盐(HMDP)进行的同位素扫描显示示踪剂到达延迟且有滞留现象。磁共振成像(RMI)似乎显示信号有异常改变。唯一的治疗方法是手术,必须对浅筋膜和深筋膜进行切开减压,并打开肌肉的肌束膜。患者术后疼痛消失,恢复了运动。