前臂筋膜间室综合征晚期的显微外科治疗

MICROSURGERY FOR LATE-STAGE FASCIAL COMPARTMENT SYNDROME OF THE FOREARM

①目的 探讨前臂筋膜间室综合征晚期有效的临床治疗方法。②方法 对 1 6例 (男 1 3例 ,女 3例 ;年龄 5～ 34岁 ,平均 1 7.5岁 )前臂筋膜间室综合征晚期病人进行显微外科手术治疗 ,单纯行肌腱“Z”字延长术或屈指深、浅肌腱替代缝合术 3例 ,行肌腱转位重建屈伸功能术 5例 ,同时行肌腱转位、肌腱延长术 7例 ;行背阔肌皮瓣转位重建屈肌功能 1例。③结果 经过 0 .5～ 1 .0年 (平均 2 70d)的随访 ,按TAM系统评估法判断疗效 ,1 6例病人中优 2例 ,良 9例 ,中 3例 ,差 2例。优良率为 68.7%。④结论 对轻、中度病人行肌腱转位、肌腱延长术 ,重度病人行肌腱转位。

Objective\ To assess effective clinical therapy for late stage fascial compartment syndrome of the forearm. Methods\ 16 cases (male 13,female 3), aged from 5 to 34 years, received microsurgery for the syndrome. The operations performed were as follows: simple Z fashion tendon lengthening or tendon transfers (3 cases); tendon transfer and reconstruction of extension and flexion(5 cases); Z fashion tendon lengthening and tendon transfers (7 cases) and transfer of musculocutaneous lattisimus dorsi flap for reconstruction of flexion function (1 case).\ Results\ 16 cases were followed up for 9 months (ranged from 6 months to 1 year).The outcome was assessed based on TAM standard. The overall excellent and good rate was 68.7%.\ Conclusion\ Tendon transfer and tendon lengthening apply to mild and moderate cases of late stage fascial compartment syndrome of the forearm while tendon transfer and musculocutaneous flap apply to severe ones.