Kadiyala R K, Waters P M
Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA.
Hand Clin. 1998 Aug;14(3):467-75.
Fractures are associated with the majority of compartment syndromes in children. Respect for associated soft-tissue injuries and recognition of specific fractures that can put a limb at risk for compartment syndrome are essential for prevention or successful treatment with early decompressive fasciotomies. In those limbs at risk for compartment syndrome, percutaneous pinning or intramedullary fixation provides fracture stabilization and prevents problems noted with standard cast treatment. Any condition that causes increased tissue pressure within a limited space can lead to compartment syndrome, however. It therefore is important to identify the injured, ill, or hospitalized child with unexplained changes in pain status or soft tissues. In particular, the agitated child with increasing analgesia requirements requires a thorough evaluation. The child's behavior should not be attributed to young age, fear, or fracture pain. This is a trap that must be avoided to prevent the disastrous outcomes of a missed compartment syndrome.
骨折与儿童大多数骨筋膜室综合征相关。重视相关软组织损伤以及识别可能使肢体有发生骨筋膜室综合征风险的特定骨折，对于预防或通过早期减压筋膜切开术成功治疗至关重要。对于有骨筋膜室综合征风险的肢体，经皮穿针或髓内固定可提供骨折稳定，并预防标准石膏治疗中出现的问题。然而，任何导致有限空间内组织压力增加的情况都可能导致骨筋膜室综合征。因此，识别疼痛状态或软组织有无法解释变化的受伤、患病或住院儿童很重要。特别是，镇痛需求不断增加的烦躁儿童需要进行全面评估。儿童的行为不应归因于年龄小、恐惧或骨折疼痛。这是一个必须避免的陷阱，以防止漏诊骨筋膜室综合征带来的灾难性后果。
