足筋膜间室综合征

FootCompartmentSyndrome

足筋膜间室综合征比小腿或前臂发生者少见。作者复习了自１９９０年５月～１９９４年４月诊治的６例患者，占同期住院筋膜间室综合征的２０％。伤后４小时～３周入院。３例伴有跖骨骨折，２例跟骨或踝关节骨折。极度肿胀，两点分辨觉减弱，足趾被动活动时剧痛，以及足背动脉变弱或消失等是早期诊断的重要体征。足筋膜间室有特殊的解剖结构，对不同的足筋膜间室综合征减压时，应选择相应的不同手术径路以达到有效减压的目的。手术并不影响正常的负重功能。随访发现４例满意，１例后遗创伤性踝关节炎，并拒绝关节融合术。作者认为高度警惕、严密观察并及时行筋膜间室切开减压是诊断和治疗足筋膜间室综合征的关键。

Comparedwiththatofthelegortheforearm,thecompartmentsyndromeofthefootismuchrare.Theauthorsreviewedtheclinicalobservationsin6casesofcompartmentsyndromeofthefoot,encounteredfromMay1990toApril1994,accountingfor20%ofthecompartmentsyndromead-mitedinthesameperiod.Therewere3menand3womenwiththeaverageageof40years.Thepa-tientswereadmitted4hoursto3weeksaftertheinjury.3caseswereassociatedwithfractureofthemetatarsals,and2caseshadfractureofthecalcaneusandtheanklejoint.Thechiefsymptomsandsignsweremarkedsweling,lossofpoweroftwo-pointdiscrimination,painonpassivemovementofthetoes,andweaknessorabsenceofthepulsationofdorsalispedicsartery.Andthesemayleadtoeralydi-agnosisofcompartmentsyndrome.Thecompartmentsofthefoothaveitsindividualstructureanddur-ingthedecompression,variousapproachmustbetakensoastohaveefectivedecompression.Asuc-cessfuldecompressionusualydoesnotaffectnormalweight-bearing.Folow-upofthesecasesrevealedsatisfactoryresultsin4casesandonehadtraumaticosteoarthritisandhadrefusedtohavejointfusion.Theauthorsbelieve,intensivecare,andtimelydecompressionarethekeypointsforthediagnosisandtimelymanagementoffootcompartmentsyndrome.