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图解｜小腿骨筋膜室综合征单切口减压技术

2022-05-16 Dr.zhang 骨科青年

软组织损伤胫腓骨骨折
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严重胫腓骨骨折、胫骨平台骨折，软组织损伤容易导致骨筋膜室综合征发生。骨嵴与腓骨间，减压前侧间室及外侧间室，后内侧切口位于胫骨嵴后缘，以减压后侧深、浅间室。单切口加压在文献中已有报道，但该切口主要的顾虑

严重胫腓骨骨折、胫骨平台骨折，软组织损伤容易导致骨筋膜室综合征发生。骨嵴与腓骨间，减压前侧间室及外侧间室，后内侧切口位于胫骨嵴后缘，以减压后侧深、浅间室。单切口加压在文献中已有报道，但该切口主要的顾虑在于对后深筋膜室可能减压不充分。国外学者详细介绍了单切口的操作步骤，可有效减压4大筋膜室，供大家参考。

小腿4大筋膜室减压通常采用前外侧与后内侧双切口减压，前外侧切口位于胫图片

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步骤1. 手术切口：沿腓骨外侧缘切开，近侧位于腓骨头远端5cm，远端位于腓骨长短肌腱腱、肌交界处。

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步骤2. 切开皮下组织，暴露筋膜。可暴露前侧、外侧及后浅筋膜室。暴露过程需注意穿支血管及腓浅神经。
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步骤3. 剥离前间室深筋膜，前间室容纳胫骨前肌、长伸肌、趾长伸肌，可在踝关节被动跖屈、背伸活动判断是否为前侧间室。

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步骤4. 减压外侧筋膜室，外侧筋膜室容纳腓骨长短肌，可在踝内翻时观察是否减压明确。

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步骤5. 减压后浅筋膜室，后浅筋膜室容纳小腿三头肌。
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步骤6. 切开减压外侧间室后，切除部分肌间隔及深筋膜，自外侧间室后方，腓骨长短肌后缘进入，暴露腓骨，然后自腓骨后缘暴露附着的后侧肌间隔，切开肌间隔暴露后深骨筋膜间室。

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    2023-01-04 ms4964546379600229

    #骨筋膜室综合征#

    0

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    2022-07-09 ms6000001317734270

    好

    0

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    2022-05-26 12498e5fm12(暂无昵称)

    #筋膜室#

    0

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    2022-05-16 飞翔国

    学习

    0

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    2022-05-12 zhouqu_8

    #综合征#

    0