Pınar DORUK, Berrin LEBLEBİCİ, Mehmet ADAM

Alçı Uygulaması Sonrası Gelişen Kompartman Sendromu: Üç olgu sunumu

Kırık stabilizasyonunda yaygın olarak kullanılan alçı uygulamalarının komplikasyonu olarak kompartman sendromu oluşabilir. Bu sendrom; dokulardaki basınç artışı, ödem veya hemoraji nedeniyle kompartman alanının azalması yada kompartman içi volüm artışına bağlı olarak gelişir. Bütün bunların sonucunda oluşan arterioler kompresyon ile kas ve sinir iskemisi oluşur. Kişinin hareketlerini kısıtlayan ,özellikle kasın pasif olarak gerilmesi ile artış gösteren şiddetli ve sürekli ağrı yaygındır. Ekstremitede şişlik, ciltte renk değişikliği, solukluk ya da arteriyel pulsasyonun alınamaması gibi dolaşım bozukluğuna ait bulgular, periferik sinir hasarına bağlı olarak sensorimotor defisitler görülebilir. Tanıda klinik bulgular, kompartman içi basınç ölçümü ve elektronöromyografi (ENMG) kullanılabilir. Etyoloji ve ağrı tedavisine ek olarak fasiyotomi, fizik tedavi modaliteleri, tendon transferleri yapılabilmektedir. Bu olgu sunumunda, kırık nedeniyle uygulanan alçı sonrası gelişen kompartman sendromuna bağlı olarak periferik sinir lezyonu saptanan üç hastayı tartışıyoruz.

Anahtar Kelimeler:

kompartman sendromu; sinir hasarı; alçı; kırık

Compartment syndrome developed due to the plaster cast :Three cases report

Compartment syndrome can occur as a result of the complication of the plaster cast applications ,which are frequently used for fracture stabilization. This syndrome occurs due to increased compartment volume or shrinking of compartment area because of edema, hemorrage or high pressure of tissues. All of these mechanisms causes arteriolar compression, resulting nerve and muscle ischemia. Intensive and continuous pain is common and limits the motions of the patient and increases with passive stretching of the involved muscles. Swelling of limb, change in skin color, peripheral vasculatory failure symptoms such as pallor,weak arterial pulsation and as a result of peripheral nerve damage, sensorimotor deficit can also be observed. Clinical evaluation, measure of pressure within the compartment, and electroneuromyography (ENMG) can be used for the diagnosis. In addition to treatment of to the treatment of etiology and pain, further treatment options such as fasciotomy, physiotherapy modalities, tendon transfers, can be performed. In this case report, we will discuss three patients with nerve lesions as a result of the compartment syndrome that developed due to the plaster casting of bone fractures.

Keywords:

compartment syndrome; nerve injury; cast; fracture,

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Yazışma Adresi / Address for Correspondence: Dr. Pınar Doruk Başkent Üniversitesi Adana Sağlık Yerleşkesi Fizik Tedavi Bölümü ı ADANA e-mail: doruk.pinar@gmail.com geliş tarihi/received :12.03.2013 kabul tarihi/accepted:08.04.2013