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中华关节外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (06) : 798 -800. doi: 10.3877/cma.j.issn.1674-134X.2022.06.024

个案报道

关节镜下前交叉韧带重建术后急性骨筋膜室综合征
钟名金1, 刘澍雨1, 傅子财1, 李阔阔1, 朱伟民1,()   
  1. 1. 518000 深圳市第二人民医院 (深圳大学第一附属医院)运动医学科
  • 收稿日期:2021-07-14 出版日期:2022-12-01
  • 通信作者: 朱伟民

Acute osteofascial compartment syndrome following arthroscopic anterior cruciate ligament reconstruction

Mingjin Zhong1, Shuyu Liu1, Zicai Fu1   

  • Received:2021-07-14 Published:2022-12-01
引用本文:

钟名金, 刘澍雨, 傅子财, 李阔阔, 朱伟民. 关节镜下前交叉韧带重建术后急性骨筋膜室综合征[J]. 中华关节外科杂志(电子版), 2022, 16(06): 798-800.

Mingjin Zhong, Shuyu Liu, Zicai Fu. Acute osteofascial compartment syndrome following arthroscopic anterior cruciate ligament reconstruction[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(06): 798-800.

急性骨筋膜室综合征(acute osteofasical compartment syndrome,AOCS)是指骨、骨间膜、肌间膜和深筋膜形成的骨筋膜室内,由于各种原因导致室内压力升高,造成室内血流灌注减少而引起急性严重缺血缺氧的一种外科急症,如未早期诊断和干预,将引起截肢残废,甚至危及生命[1,2,3]。AOCS最常见的原因是肢体的严重创伤和骨折,多见于小腿和前臂[2]。其他病因还包括缺血再灌注损伤、热损伤、外包扎过紧、严重软组织感染、血管堵塞或损伤等[1,2]。关节镜手术后发生AOCS是关节镜手术后罕见的并发症[4],国内尚无相关报道。本文报道1例关节镜下前交叉韧带(anterior cruciate ligament,ACL)重建术后发生AOCS的病例。

图1 患者下肢血管造影。图A为下肢血管造影CT,示右小腿明显肿胀(白色星号示肿胀部位);图B为下肢血管成像,示右侧下肢肿胀、侧肢循环丰富,白色箭头示右侧胫前动脉纤细;图C为下肢血管三维成像,示右侧胫前动脉至足背动脉纤细,白色箭头示部分管腔显示不清
图2 小腿骨筋膜室综合征切开术过程。图A示右侧小腿明显肿胀,张力高;图B小腿骨筋膜间隔切开后,小腿张力消失、肿胀减轻;图C示伤口VSD(创面封闭式负压引流技术)覆盖伤口;图D去除VSD并缝合伤口
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