Yen C Y, Yeh W L, Tu Y K
Department of Trauma, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1998 Sep;21(3):358-61.
Compartment syndromes occurring in the forearm and leg are not infrequent. However, reports of compartment syndrome of the upper arm are conspicuously rare. Inferior dislocation of the shoulder combined with compartment syndrome has rarely been reported in the literature. We report our experience with a patient with inferior dislocation of the glenohumeral joint combined with compartment syndrome of the upper arm. A 29-year-old man had traumatic inferior dislocation of the glenohumeral joint combined with severe swelling of the shoulder and upper arm. After close reduction, the shoulder and upper arm were still tensely swollen. Compartment pressure of the upper arm was measured using a digital manometer (Quick Pressure Monitor 295-1, Stryker) and remained very high, thus, fasciotomy was performed. After debridement and skin graft, the arm healed without sequelae. When a patient has a fracture dislocation of the shoulder joint associated with a swollen arm, compartment syndrome of the upper arm should be included as a differential diagnosis. Detecting the compartment pressure can confirm the diagnosis of compartment syndrome objectively.
前臂和腿部发生骨筋膜室综合征并不罕见。然而，上臂骨筋膜室综合征的报道却极为罕见。肩关节下脱位合并骨筋膜室综合征在文献中鲜有报道。我们报告了一例肱盂关节下脱位合并上臂骨筋膜室综合征患者的治疗经验。一名29岁男性因创伤导致肱盂关节下脱位，同时伴有肩部和上臂严重肿胀。手法复位后，肩部和上臂仍肿胀紧绷。使用数字压力计（Stryker公司的Quick Pressure Monitor 295-1）测量上臂骨筋膜室压力，结果显示压力仍然很高，因此进行了筋膜切开术。清创及植皮后，手臂愈合良好，未留后遗症。当患者出现肩关节骨折脱位并伴有手臂肿胀时，应将上臂骨筋膜室综合征纳入鉴别诊断。检测骨筋膜室压力可客观地确诊骨筋膜室综合征。
