儿童前臂筋膜室综合征的不典型表现

Q4 Medicine

Trauma Case Reports Pub Date : 2025-04-14 DOI:10.1016/j.tcr.2025.101170

P.A. Saxena , M. Veylamuthen , L. Kitsi , A. Crawford , A.P. Dekker , N. Ashwood

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引用次数: 0

摘要

背景：儿童间室综合征（CS）在儿科人群中很少见，诊断具有挑战性。已知非典型或延迟治疗CS的结果较差。我们报告一个8岁女孩的非典型CS的表现和她的处理。在本病例报告中，我们讨论了一名8岁女孩桡骨中轴开放性骨折和尺骨骨折采用钛弹性钉系统（TENS）治疗的病例。她在受伤后2周出现明显的疼痛，手指屈曲和烦躁。在紧急前臂筋膜切开术和腕管减压后，她的症状得到改善。72小时后，她的筋膜切开术伤口愈合，症状继续改善。伤后9周，前臂骨折放射愈合。伤后6个月取下TENS指甲。损伤后8个月，患者无功能性运动障碍，但正中神经分布存在残余感觉障碍。结论小儿cs需要高度的怀疑指数。除了基数5P的CS征象外，3A的三联征也被提出用于儿童CS的诊断。在非典型表现或延迟诊断病例中，长期结果是有利的。

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Atypical presentation of forearm compartment syndrome in a child

Background

Compartment syndrome (CS) in children is rare in the paediatric population and diagnosis is challenging. Atypical or delayed management of CS has been known to have poor outcomes. We report an 8-year-old girl with an atypical presentation of CS and her management.

Case report

In this case report, we discuss the case of an 8-year-old girl with an open fracture of the midshaft radius and ulna fracture managed with Titanium elastic nailing system (TENS). She presented 2 weeks post injury with significant pain, flexed fingers and agitated. Following an urgent forearm fasciotomy and carpal tunnel decompression, her symptoms improved. 72 hours later, her fasciotomy wounds were closed and her symptoms continued to improve. 9 weeks post injury her forearm fracture had radiological union. 6 months post injury her TENS nails were removed.8 months post injury, she had no functional motor deficit but residual sensory deficit in median nerve distribution.

Conclusion

CS requires a high index of suspicion in the paediatric population. In addition to cardinal 5P's signs of CS, a triad of 3A's has been proposed for diagnosis of CS in children. Long term outcomes are favourable in atypical presentations or delayed diagnosis cases.

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来源期刊

Trauma Case Reports Medicine-Emergency Medicine

CiteScore

0.60

自引率

0.00%

发文量

131

审稿时长

26 weeks

期刊介绍： Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.