足部骨筋膜室综合征早期诊断与治疗

目的：探讨足趾氧饱和度监测下足背双切口减压在治疗足部骨筋膜室综合征的作用。方法：2000年1月至2007年6月收治26例足骨筋膜室综合征患者,男22例,女4例;年龄22～68岁,平均36.3岁。在足趾氧饱和度监测下,行足背双切口减压,减压后3～10d行减张缝合或植皮术。按照美国足踝骨科协会的足部评分标准（AOFAS）,对术后患者疼痛、功能和自主活动、支撑情况等进行观察,评价术后功能。结果：26例获随访,时间6～43个月,平均19个月,全部患者创口均愈合良好。AOFAS总评分由术前的（30.4±8.0）分提高到术后的（92.5±5.0）分（t=3.13,P〈0.01）;治疗结果：优21例,良4例,差1例。结论：严重暴力引起的足部骨折、脱位、肿胀、挫伤,早期应密切注意足部骨筋膜室综合征,一经确诊立即进行筋膜室切开彻底减压。足趾氧饱和度监测和背侧双切口减压方法简便、效果满意,如骨折移位、脱位明显者可同时行内固定治疗。

Early diagnosis and therapy of osteofascial compartment syndrome of the foot

Objective: To investigate the effects of decompresion through double-incision of foot dorsum on the treatment of osteofascial compartment syndrome of the foot under the monitoring of saturation of blood oxygen. Methods: From January 2000 to June 2007,26 cases of osteofascial compartment syndrome of the foot were decompressed through double-incision of foot dorsum under the monitoring of saturation of blood oxygen,and relaxation suture or skin grafting were operated within 3 to 10 days after decompressing. Among them,22 patients were males and 4 were females,with an average age of 36.3 years old ranging from 22 to 68 years. According to AOFAS system,the pain,function,autonomic activities and suport were evaluated. Results: All patients were followed-up for from 6 to 43 months with the average of 19 months. All patients were healed. According to AOFAS system,the total scores increased from preoperative(30.4±8.02) to postoperative(92.5±5.0)(t=3.13,P<0.01);the results were excellent in 21 cases,good in 4 and poor in 1. Conclusion: The patients of fracture-dislocated,swelling and injured in the soft tissue because of severe violence should observed closely on osteofascial compartment syndrome of the foot early. Feet are operated and thoroughly decompressed as soon as it is diagnosed as the compartment syndrome. Osteofascial compartment syndrome of the foot decompressed by foot dorsum double-incision is convenient and satisfied,and the operation is performed by internal fixation if it is displacedly fractured at the same time.