医学
横纹肌溶解症
筋膜切开术
挤压伤
病因学
舱室(船)
挤压综合征
筋膜间隔综合征
重症监护医学
人口
麻痹
病理生理学
外科
麻醉
内科学
海洋学
止痛药
地质学
环境卫生
不利影响
作者
John J. Fernandez,Shelby R. Smith
标识
DOI:10.5435/jaaos-d-23-00734
摘要
Traumatic rhabdomyolysis is a systemic manifestation of muscle injury and can occur from various traumatic etiologies, including crush syndrome (CrshS) and compartment syndrome (CS). Although historically described in natural disaster survivors trapped under collapsed structures, the frequency of CrshS has increased in the setting of ‘found down’ patients from opioid overdoses. Signs and symptoms of the injured limb in CrshS may range from pressure-induced skin changes to neurologic deficits and paralysis. Although its pathophysiology differs from CS, severe injuries may lead to an associated CS. Identifying CS in a patient with CrshS can be difficult but is important to distinguish because it affects treatment. The degree of muscle damage, viability of the remaining muscular compartment, and presence of elevated compartment pressures dictate the need for surgical intervention in the form of fasciotomy. Surgical outcomes from CrshS and delayed CS result in similar high morbidity and surgical complications. This review defines and classifies the types of traumatic rhabdomyolysis and summarizes the outcomes to facilitate timely diagnosis and appropriate management for this population to reduce morbidity associated with these conditions.
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