コンパートメント症候群を併発した前脛骨筋腱断裂の1治療例

Traumatic Anterior Tibialis Tendon Rupture with Compartment Syndrome

　【目的】コンパートメント症候群を併発した前脛骨筋断裂に対し，縫合のうえ創外固定と筋膜切開を行い良好な結果を得たので報告する．【方法】2トントラック運転中に約40分間左下腿を挟まれて救出された．前脛骨筋腱を縫合し，創外固定を施行し，外側コンパートメント内圧が85mmHgと高値なため減張切開を施行した．【結果】術後外側は11mmHgと改善し，術後4週間で創外固定を抜去し，足関節の自動運動を開始した．【結論】コンパートメント症候群を合併した前脛骨筋断裂の固定に創外固定は有効である．

　We report a case of anterior tibialis tendon rupture with compartment syndrome of the lower leg. A 21-year-old man who had been trapped in the driver's seat for 40 minutes after a traffic accident was admitted with an injury of the lower left leg. After direct suturing of the anterior tibialis tendon, the ankle joint was stabilized with an external fixation system, and decompressive facsiotomy was performed to reduce the compartment pressure in the left leg. The compartment pressure had returned to normal 4 weeks after admission, at which time the external fixation system was removed and active movement exercise was started. We want to emphasize the possibility of compartment syndrome after injuries. It is very useful to stabilize the ankle joint with an external fixation system before decompressive facsiotomy.