王德刚

[摘要] 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。

[关键词] 胫腓骨粉碎性骨折；骨筋膜室综合征；早期处理；内固定

[中图分类号] R683.4   [文献标识码] B   [文章编号] 2095-0616（2014）08-206-02

The early treatment of compartment syndrome caused by comminuted bone fracture

WANG Degang

Fuyuan County Fucun Center Hospital in Yunnan Province,Fuyuan 655504,China

[Abstract] 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.

[Key words] Comminuted fracture;Compartment syndrome;Early treatment;Fixation

胫腓骨粉碎性骨折是煤矿常见的骨折类型之一，在煤炭生产的过程中由于其作业环境差，空间较小，地质条件多变，经常受顶板、煤矿机械等灾害的威胁，常导致煤矿工人发生胫腓骨粉碎性骨折[1]。胫腓骨粉碎性骨折后使骨筋膜室内压力升高，导致神经、肌肉急性缺血，出现一系列的症状、体征，形成骨筋膜室综合征。骨筋膜室综合征一旦发现，应早期发现和及时处理，早期切开减压，才能挽救患肢，将患者的痛苦降低到最低程度。

1 资料与方法

1.1 一般资料

将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例作为观察对象，其中男20例，女10例；……