Ovre S, Hvaal K, Holm I, Strømsøe K, Nordsletten L, Skjeldal S
Orthopaedic Department, Ullevål Hospital, Oslo, Norway.
Arch Orthop Trauma Surg. 1998;118(1-2):29-31. doi: 10.1007/s004020050305.
During the past few years we have monitored tissue pressure in patients treated with intramedullary nailing of tibial shaft fractures. A value of 30 mmHg has been used as the threshold for fasciotomy. The purpose of this study was to evaluate this practice. Sixty-three patients were included in the series. Forty-three fractures were closed, 18 grade I (Gustilo) and two grade II. Tissue pressure measurements were performed in 43 patients. Eighteen legs were treated with decompressive fasciotomy, three on clinical findings alone, and 15 after measurement of a pressure higher than 30 mmHg. This gives a fasciotomy rate of 29%. At follow-up two patients were dead. All fractures were healed, and there were no major complications such as deep infection, extensive muscle necrosis, paresis or short-foot syndrome. Three fasciotomized patients had significantly reduced muscle strength compared with the contralateral leg.
在过去几年中，我们对接受胫骨干骨折髓内钉治疗的患者的组织压力进行了监测。30 mmHg的值已被用作筋膜切开术的阈值。本研究的目的是评估这种做法。该系列纳入了63例患者。43例骨折为闭合性骨折，18例为I级（ Gustilo），2例为II级。对43例患者进行了组织压力测量。18条腿接受了减压筋膜切开术，3条仅根据临床发现进行治疗，15条在测量压力高于30 mmHg后进行治疗。这使得筋膜切开术的发生率为29%。随访时有2例患者死亡。所有骨折均愈合，且未出现深部感染、广泛肌肉坏死、麻痹或短足综合征等重大并发症。与对侧腿相比，3例接受筋膜切开术的患者肌肉力量明显减弱。
