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首页> 外文期刊>Injury >The 'silent' compartment syndrome.
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The 'silent' compartment syndrome.

机译：“沉默的”隔室综合征。

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Intractable pain out of proportion to the injury sustained is considered to be the earliest and most reliable indicator of a developing compartment syndrome. We report 4 cases where competent sensate patients developed compartment syndromes without any significant pain. The first patient developed a painless compartment syndrome in the well leg following surgery for femoral fracture on the other side. The second patient developed the silent compartment syndrome post-operatively following a tibial nailing for a tibial fracture. The third patient presented with the painless compartment syndrome following a tibial plateau fracture. Our prevailing culture of a high-index of clinical suspicion and surveillance prompted us to perform compartment pressure measurements. The surgical findings at immediate fasciotomy confirmed the diagnoses. Our experience indicates that pain is not a reliable clinical indicator for underlying compartment syndrome, so in a competent sensate patient the absence of pain does not exclude compartment syndrome. We believe that a high index of clinical suspicion must prevail in association with either continuous compartment pressure monitoring or frequent repeated documented clinical examination with a low threshold for pressure measurement.
机译：与所遭受的伤害不成比例的顽固性疼痛被认为是发展性房室综合征的最早且最可靠的指标。我们报告了4例有知觉能力的患者发展了车厢综合症，而没有任何明显的疼痛。首例患者在另一侧因股骨骨折而手术后，在井下腿出现了无痛性室综合征。第二名患者在胫骨骨折的胫骨钉手术后出现了无声隔室综合征。第三位患者在胫骨平台骨折后出现无痛性室综合征。我们盛行的对临床高度怀疑和监视的文化促使我们进行隔室压力测量。立即筋膜切开术的手术结果证实了诊断。我们的经验表明，疼痛不是潜在的隔室综合征的可靠临床指标，因此在有能力的有知觉的患者中，不存在疼痛并不排除隔室综合征。我们认为，必须与连续的隔室压力监测或频繁重复记录的临床检查相结合，以较低的压力测量阈值来进行临床怀疑。

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