投掷者骨折并继发室间隔综合征,需要紧急进行上肢两室筋膜切开术。

HCA healthcare journal of medicine Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI:10.36518/2689-0216.1727
Andrew Wise, Darwin Ang
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引用次数: 0

摘要

导言:投掷者骨折是指肱骨第三节中段至远端骨折,通常表现为投掷动作时发出 "啪 "的一声,并伴有剧烈的手臂疼痛。虽然以前的文献中也描述过投掷者骨折,但本报告是第一份证明室间隔综合征是其潜在后遗症的报告:一名 25 岁的半职业投手在投球后因右臂剧烈疼痛到急诊科就诊。他描述自己听到了 "啪 "的一声,随后感到剧烈疼痛。经检查发现,他的上臂筋膜室压力升高,于是被紧急送往手术室,进行了双筋膜室切开术。投掷者骨折的典型症状是听到 "啪 "的一声,随后手臂疼痛,多见于 20-30 岁的男性患者,发生在投掷的加速阶段。众所周知的潜在后遗症是桡神经麻痹,约有 5-11% 的患者会出现这种情况。之前未曾描述过的一种后遗症是随后出现的隔室综合征:结论:应监测投掷者骨折患者的室间隔综合征,因为这是一种随后可能发展为威胁肢体的疾病。
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Thrower's Fracture With Subsequent Compartment Syndrome Requiring Emergent 2 Compartment Upper Extremity Fasciotomy.

Introduction: A thrower's fracture is a mid-to-distal third humerus fracture that commonly presents as an audible pop with severe arm pain sustained during the throwing motion. Although thrower's fracture has been described previously in the literature, this report is the first to demonstrate compartment syndrome as its potential sequel.

Case presentation: A 25-year-old semi-professional pitcher presented to the emergency department with severe right arm pain following a pitch. He described hearing an audible pop with subsequent severe pain. He was found to have elevated compartment pressures in his upper arm and was rushed to the operating room for a 2 compartment fasciotomy. The thrower's fracture classically presents as an audible pop with subsequent arm pain in male patients aged 20-30 years during the acceleration phase of throwing. A potential well-known sequel is radial nerve palsy, which occurs in roughly 5-11% of patients. A sequel which has not been previously described is the subsequent development of compartment syndrome.

Conclusion: Compartment syndrome should be monitored in patients with thrower's fractures, as it is a limb-threatening condition that can subsequently develop.

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