| Objective:①Through the anatomy study, design the lateral incision open crus four bone fascia room proof that the surgical anatomic feasibility.②Making dogs crus osteofascial compartment syndrome of animal models and use the lateral incision decompression treatment, test the validity of this method.③Based on the lateral incision rows of curs bone fascia room decompression and postoperative cooperate with Tao Hong Si Wu soup decoction clinical cases of research and analysis, discusses this treatment efficacy and advantages.Materials and methods:①This experiment specimens for 5 side fresh frozen adult calf. Design the lateral incision open crus four bone fascia room surgical approach, and in the specimen uplink lateral incision simulation surgery, then press the surgical approaches, observing pterional incision and four bone fascia room with the relationship and the peroneal nerve, phil shallow nerve, phil deep nerve and peroneal artery relationship.②Select healthy adult hybrid dogs only (26 kidneys) 13 in 15-20kg (weight, male and female unlimited) Experiments using Whiteside method for measuring before dog of the fascia room after the normal pressure, according to Wang Zhi Gang little leg muscle film syndrome of animal models of production method of producing animal models, in animal models uplink lateral incision fascia room decompression, again measure its bone fascia chamber pressure Spss16 statistical software, through to the collected data processing, observe whether after decompression organizational pressures below levels dropped to normal and postoperative crus recovery.③The curs to collect cases of osteofascial compartment syndrome by the surgical method and postoperative cooperate with Tao Hong Si Wu soup treatment, after 3 months Ewards evaluation system based on functional recovery degree evaluation this calf.Results:①That the lateral incision from anatomy and unlock crus four bone fascia room feasibility.The peroneal neck from the lateral incision under lateral malleolus 2cm pointed to the 5cm, lateral incision direct lateral fascia room, incision longitudinal incision forward side bone muscle film room, incision to rear can hold opened longitudinally shallow bone fascia room, will the lateral bone fascia rooms and shallow bone fascia room after respectively after forward edge in (?)ibula after a longitudinal incision peroneal deep bone fascia room, to open up to four bone fascia (?)oom. Phil shallow nerve and peroneal artery with surgical approach approaching, intraoperative should avoid damage.②Successful creation 20 sides animal models, through the lateral incisioi bone fascia room decompression, make dogs of the fascia chamber pressure by preoperativ 33.3±2.18mmHg fell to 6±3.56mmHg normal levels below, P=0.0003, P<0.001, before and afte decompression of the fascia dog has significant difference chamber pressure.③In the clinica application of 8 cases,7 postoperative condition rapidly control,1 case for more than 24 hours clinical time wound infection occurred after muscle necrosis, give debridement part eliminate(?) many times the necrotic tissue healing, but appears after changeover calf ischemic muscle contracture. All cases, three months later, Edwards evaluation system according to excellent 7case medium lcase,disqualification 1 case.Conclusion:①Through the anatomy and animal studies confirm the lateral incision ma; simultaneously completely unwind crus four bone fascia room, and clinical application initiall proved that this method is effective.②The lateral incision healing curs osteofascial compartmen syndrome has reduced pressure fully, damage smaller. Protects both skin deep fascia vascula integrity between perforator, may have been for second crus inside flap transfer saved for area, and can avoid tibia lateral and steel exposed. Operation simple, can widely used in clinic.③Tao Hong Wu soup in curs osteofascial compartment syndrome postoperative function recovery has its certaii aspects of auxiliary function, deserves further study. |
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