胫腓骨粉碎性骨折所致骨筋膜室综合征的早期处理

The early treatment of compartment syndrome caused by comminuted bone fracture

目的：探讨胫腓骨粉碎性骨折所致骨筋膜室综合征的早期处理，旨在早期发现和及时处理，早期切开减压，挽救患肢，将患者的痛苦降低到最低程度。方法回顾性分析2006年1月～2011年1月我院收治的胫腓骨粉碎性骨折所致骨筋膜室综合征患者30例的临床资料。结果30例胫腓骨粉碎性骨折患者均获得随访，随访7~24个月，发生浅表感染5例，深部感染1例，骨髓炎1例，钉孔感染4例,无一例发生缺血性挛缩及肢体致残。17例半年内骨性愈合，3例延迟愈合，平均愈合时间（8.5±1.2）个月。疗效评价：优12例，良5例，差3例，优良率为75%。结论对于胫腓骨粉碎性骨折合并骨筋膜室综合征早期诊断是关键，果断切开减压是疗效的保障。

Objective To investigate early treatment of comminuted fracture of bone caused by compartment syndrome,aimed at early detection and timely treatment, early decompression,limb salvage,to reduce the patient＇s pain to a minimum. Methods The clinical data of 30 cases patients with compartment syndromes caused by comminuted bone fracture were retrospective analyzed from January 2006 to January 2011 in our hospital. Results Among 30 cases of comminuted fracture patients were followed up for 7-24 months,5 cases occurred superficial infection,1 case occurred deep infection,1 case occurred osteomyelitis,4 cases occurred nail holes infection,no one occurred ischemic contracture and limb disability. 17 cases of bone healing half of one year,3 cases of delaying union,the average healing time was（8.5±1.2） months.The effect Evaluation showed：excellent in 12 cases,good in 5 cases,and poor in 3 cases,the good rate was 75%. Conclusion The early diagnosis for compartment syndrome caused by comminuted fracture is critical,decisive decompression is the protection for the efficacy.