Novosti
Khirurgii
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Year 2010 Vol. 18 No 4

LECTURES, REVIEWS

O.P. KEZLYA, L.V. GIVOYNO

ACUTE COMPARTMENT SYNDROME AS A COMPLICATION OF FRACTURES OF SHIN BONES

An acute compartment syndrome is rather a widespread complication of the fractures of the shin bones though its symptoms are frequently unnoticed resulting in unsatisfactory functional results of treatment. In the article the problems concerning etiology, pathogenesis of acute compartment syndrome at the fractures of the shin bones are studied. Principles of this condition diagnostics are viewed as well as the management tactics of acute compartment syndrome: indications for fasciotomy, conservative methods of treatment. The most reliable diagnostic method of acute compartment syndrome is the change of the interstitial pressure. But the level of the interstitial pressure at which one has to carry out fasciotomy up to present moment remains discussible. ItТs more preferable to perform full fasciotomy with the disclosure of all fascia casings.

Keywords: fractures of shin bones, compartment syndrome, fasciotomy
p. 146-156 of the original issue
References
  1. —околов, ¬. ј. ћножественные и сочетанные травмы: практическое рук. дл€ врачей-травматологов / ¬. ј. —околов. Ц ћ., 2006. Ц 512 с.
  2. Ћечение открытых переломов костей голени стержневыми аппаратами / ј. ¬. √ородниченко [и др.] // „еловек и его здоровье. “равматологи€, ортопеди€, протезирование, биомеханика, реабилитаци€ инвалидов: материалы конгр. Ц —ѕб., 1997. Ц —. 22-23.
  3. Compartment pressures after closed tibial shaft fracture: their relation to functional outcome / P. D. Triffitt [et al.] // J. Bone Jt. Surg. Ц 1992. Ц Vol. 74-B. Ц P. 195-198.
  4. McQueen, M. M. Acute compartment syndrome in tibial diaphyseal fractures / M. M. McQueen, J. Christie, C. M. Court-Broun // J. Bone Jt. Surg. Ц 1996. Ц Vol. 78-B Ц P. 95-98.
  5. Moehring, H. D. Compartment pressure monitoring during intramedullary fixation of tibial fractures / H. D. Moehring, J. P. Voigtlander // Orthopedics. Ц 1995. Ц Vol. 18, N 7. Ц P. 631-635.
  6. Blick, S. S. A Compartment syndrome in open tibial fractures / S. S. Blick, R. J. Brumback, A. J. Poka // Bone Jt. Surg. Ц 1986. Ц Vol. 68-A. Ц P. 1348-1353.
  7. Clough, T. M. Audit of open tibial diaphyseal fracture management at a district accident centre / T. M. Cloug, R. S. Bale // Ann. R. Coll. Surg. Engl. Ц 2000. Ц Vol. 82, N 6. Ц P. 436-440.
  8. Seekamp, A. Hannover Fracture Scale Т98Чreevaluation and new prospects for an established score system / A. Seekamp, H. Kontopp, H. Tscherme // Unfallchirurg. Ц 2001. Ц Bd 104, N 7. Ц S. 601-610.
  9. Woll, T. S. The segmental tibial fracture / T. S. Woll, P. J. Duwelius // Ibid. Ц 1992. Ц N 281. Ц P. 204-207.
  10. јнкин, Ћ. Ќ. ѕрактическа€ травматологи€. ≈вропейские стандарты диагностики и лечени€ / Ћ. Ќ. јнкин, Ќ. Ћ. јнкин. Ц ћ., 2002. Ц —. 339-343. Ц 480 с.
  11. Volkmann, R. Ischaemic muscle paralyses and contractures / R. Volkmann // Clin. Orthop. Ц 1881. Ц N 50. Ц P. 5.
  12. Leiser, E. Untersuchungen uber ischдmischen Muskellahmungen und Muskelkon-trakturen / E. Leiser // Samml. Klin. Vortage. Ц 1884. Ц N 249. Ц P. 2087.
  13. Effects of local compression on peroneal nerve function in humans / A. R. Hargens [et al.] // J. Orthop. Res. Ц 1993. Ц N 11. Ц P. 818-827.
  14. Littlewood, H. Some complications following on injuries about elbow-joint and their treatment / H. Littlewood // Lancet. Ц 1900. Ц P. 290-292.
  15. Murphy, J. B. Myositis / J. B. Murphy // JAMA Ц 1914. Ц Vol. 63. Ц P. 1249-1255.
  16. Brooks, B. Pathologic changes in muscle as a result of disturbances of circulation:an experimental study of VolkmannТs ischemic paralysis / B. Brooks // Arch. Surg. Ц 1922. Ц N 5. Ц P. 188-216.
  17. Wells, H. S. Tissue pressure (intracutaneous, subcutaneous, and intramuscular) as related to venous pressure, capillary filtration, and other factors / H. S. Wells, J. B. Youmans, D. G. Miller // J. Clin. Invest. Ц 1938. Ц Vol. 17 Ц P. 489-499.
  18.  адри Ћама, ƒ. ќсобенности хирургического лечени€ закрытых переломов костей предплечь€ с учетом стадии развити€ внутритканевого гипертензионного синдрома: дис. Е канд. мед. наук / ƒ.  адри Ћама.Ц –остов н/ƒ, 2003. Ц 253 с.
  19. Nylander, G. Value of streptokinase and heparin in treatment of acute deep vein thrombosis / G. Nylander, H. Semb // Surg. Gynec. Obstet. Ц 1972. Ц Vol. 132. Ц P. 974-976.
  20. Matsen, F. A. Monitoring of intramuscular pressure / F. A. Matsen, R. A. Winquist, R. B. Jr. Krugmire // J. Bone Joint Surg.(Amer.). Ц 1980. Ц Vol. 62A. Ц P. 286-291.
  21. The Wick catheter technique for measurement of intramuscular pressure / S. J. Mubarack [et al.] // J. Bone Joint Surg. Ц 1978. Ц Vol. 60-A. Ц P. 1091-1095.
  22. Thomas, G. Compartment syndrome: an extremity at risk / G. Thomas, Jr. M. D. Shirreffs // Emergency medicine. Ц 1990. Ц P. 103-110.
  23. Tissue pressure measurements as a determinant for the need of fasciotomy / T. E. Whitesides [et al.] // Clin. Orthop. Ц 1975. Ц Vol. 113. Ц P. 43.
  24. Kolman, J. Ethics and methods in surgical trials / J. Kolman, M. Slavick, B. Soukuy // Acta Chir. Orthop. Ц 1995. Ц N 4. Ц P. 232-235.
  25. Ѕессмертный, ё. ј. ћестный гипертензивно-ишемический синдром (компартмент-синдром) ампутационных культей нижних конечностей / ё. ј. Ѕессмертный, ќ. Ё. ћихневич // ”краин. мед. журн. Ц 2006. Ц є 2 (52). Ц —. 71-75.
  26. Ћитвина, Ќ. ј. —осто€ние кровообращени€ верхних конечностей у больных с диафизарными переломами костей предплечь€: дис. Е канд. мед. наук / Ќ. ј. Ћитвина. Ц ѕрокопьевск, 1977. Ц 186 c.
  27. Delayed use of hyperbaric oxygen for treatment of a model anterior compartment syndrome / M. B. Strauss [et al.] // J. Orthop. Res. Ц 1996. Ц N 4. Ц P. 108-111.
  28. Reduction of skeletal muscle necrosis using intermittent hyperbaric oxygen in a model compartment syndrome / M. B. Strauss // J. Bone and Joint Surg. Ц 1983. Ц Vol. 65A. Ц P. 656-659.
  29. Amendola, A. Acute compartment syndrome / A. Amendola, C. H. Rorabeck, D. Vellet // Am. J. Sports Med. Ц 1990. Ц Vol. 18, N 1. Ц P. 29-34.
  30. Jensen, S. L. Maintenance therapy with unprocessed bran in the prevention of acute anal fissure recurrence / S. L. Jensen, A. Olsen // Journal of the Royal Society of Medicine. Ц 1986. Ц Vol. 79. Ц P. 300-301.
  31. Ultrasound evaluation of the anterior musculofascial compartment of the leg following exercise / D. H. Gershuni, B. B. Gosink, A. R. Hargens // Clin. Orthop. Ц 1982. Ц Vol. 187. Ц P. 185-189.
  32. Effect of ankle position and a plaster cast on intramuscular pressure in the human leg / G. Weiner [et al.] // J. Bone Jt. Surg. Ц 1994. Ц Vol. 76-A. Ц P. 1476-1481.
  33. Kjellmer, I. An indirect method for estimating tissue pressure with special reference to tissue pressure in muscle during exercise / I. Kjellmer // Acta Physiol. Scand. Ц 1964. Ц N 62. Ц P. 31-40.
  34. Styf, J. R. Abnormally increased intramuscular pressure in human legs: comparison of two experimental models / J. R. Styf, P. Wiger // J. Trauma. Ц 1998. Ц N 45. Ц P. 133-139.
  35. Wiger, P. The effects of limb elevation and increased intramuscular pressure on nerve and muscle function in the human leg / P. Wiger, Q. Zhang, J. Styf // Eur. J. Appl. Physiol. Ц 2000. Ц Vol. 83, N 1. Ц P. 84-88.
  36. Zang, Q Effects of limb elevation on increased intramuscular pressure on human tibialis anterior muscle blood flow / Q. Zang, J. Styf, L. G. Lindberg // Eur. J. Appl. Physiol. Ц 2001. Ц N 85. Ц P. 567-571.
  37. The effect of limb elevation and dependency on local arteriovenous gradients in normal human limbs with increased tissue pressure / F. A. Matsen [et al.] // Clin. Orthop. Ц 1980. Ц N 150. Ц P. 187-195.
  38. Buchbinder, D. Hypertonic mannitol: its use in the prevention of revascularization syndrome after acute arterial ischemia / D. Buchbinder, A. M. Karmody, R. P. Leather // Arch. Surg. Ц 1981. Ц Vol. 116. Ц P. 414-418.
  39. Hutton, M. The lowering of postischemia compartment pressures with mannitol / M. Hutton, R. S. Rhodes, G. Chapman // J. Surg. Res. Ц 1982. Ц Vol. 32 Ц P. 239-241.
  40. Rorabeck, C. H. Anterior tibial compartment syndrome: a clinical and experimental review / C. H. Rorabeck, I. MacNab // Clin. Orthop. Relat. Res. Ц 1975. Ц N 113. Ц P. 52-57.
  41.  лючевский, ¬. ¬. ’ирурги€ повреждений / ¬.¬.  лючевский. Ц ярославль, 1990. Ц 845 c.
  42. Cooper, G. G. Delayed presentation of bilateral popliteal artery injury / G. G. Cooper // Eur. J. Vasc. Surg. Ц 1992. Ц N 6. Ц P. 659-661.
  43. Clinical results of dermatomy-fasciotomy / S. B. Johnson [et al.] // Am. J. Surg. Ц 1992. Ц Vol. 164. Ц P. 286-290.
  44. Interstitial fluid pressure in muscle and compartment syndromes in man / A. R. Hargens [et al.] // Microvasc. Res. Ц 1977. Ц N 14. Ц P. 1-10.
  45. Quantitation of skeletal muscle necrosis in a model compartment syndrome / A. R. Hargens [et al.] // J. Bone Jt. Surg. Ц 1981. Ц Vol. 63-A. Ц P. 631-636.
  46. The compartment syndrome: an experimental and clinical study of muscular energy metabolism using phosphourus nuclear magnetic resonance spectroscopy / R. B. Heppenstall [et al.] // Clin. Orthop. Ц 1997. Ц N 46. Ц P. 303-308.
  47. Lower limb compartment syndrome: course after delayed fasciotomy / J. A. Finkelstein [et al.] // J. Trau. Ц 1996. Ц N 40. Ц P. 342 -344.
  48. Reis, N. D. Crush injury of the lower limbs / N. D. Reis, M. Michaelson // J. Bone Jt. Surg. Ц 1986. Ц Vol. 68-A. Ц P. 414-418.
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