Tardive hemorrhoea cause of osteofascial compartment syndrome after trauma / 中国矫形外科杂志

ABSTRACT

[Objective]To analyze the reason for osteofascial compartment syndrome caused by tardive massive bleeding and to discuss the first-aid measure to treat continuing bleeding in operation.[Method]There were 5 cases in this study.Two osteofascial compartment syndrome with tardive haematoma were caused by secondary disturbances of blood coagulation.One iliopsoas muscle haematoma was caused by over-dose of warfarin(WARF).Vitamine K was applied to anti-warfarin and depressed haematoma by ultrasonic guiding puncturation aider a pause of warfarin.The other one suffered from continuing bleeding after a depression operation on right femoral bone haematoma.The bleeding could not be stopped until carbasus obturation and a supplementary of lood coagulation factor.The carbasus were taken out 36 hours later.Three traumatic pseudoaneurysm rupture happened to superior gluteal artec,arteriae tibialis posterior and deep femoral artery separately.The bleeding artery was ligated and removed the body of the blood tumor in these three cases.In addition,arterial embolism was applied in two of them before operation.[Result]No recurrence happened to the case with iliopsoas muscle haematoma after 16 weeks as a result of absorption and degeneration.As the patient with right femoral bone haematoma referred,the bleeding stopped after treated by carbasus obturation.The wound was closed 36 hours after the operation.A satisfactory sensory recovery,pulsation of dorsal pedal artery and arteria tibialis posterior were found.Rebleeding was found in 3 weeks after the wound closed.The pathobiology inspection of bone and muscle tissue around the fracture site showed osteoma sarcomatosum in right femoral bone.The author gave the patient to the operation of high amputation.No rebleeding,nervous symptoms caused by compression,limbs necrosis and ischemic contracture was found after 3 patients suffering from traumatic pseudoaneurysm rapture with followed-up from 8 month to 3 years.[Conclusion]Hemorrhea caused by secondary disturbances of blood coagulation or pseudoaneurysm can lead to osteofascial compartment syndrome.Embolism of the bleeding artery before removal of the aneurysm and haematoma can reduce bleeding in operation.It is the best choice for the doctor to stop operation immediately and stop bleeding by effective carbasus obturation.