COMPARTMENT SYNDROME DUE TO THROMBOLYTIC TREATMENT AFTER PULMONARY EMBOLISM CAUSED BY FIBULA FRACTURE

Year 2018, CASE REPORT SPECİAL ISSUE, 8 - 13, 30.07.2018

Muhammet Zeki Gültekin , Oğuz Uğur

https://doi.org/10.30569/adiyamansaglik.441740

Abstract

In this study; We aimed
to present a case of pulmonary embolism after left fibular fracture and
initiation of thrombolytic therapy, but the occurrence of cruris anterolateral
compartment syndrome after thrombolytic treatment. Thromboembolic events related to immobilization
are common in lower extremity fractures, and pulmonary embolism is the most
feared complication. In patients with pulmonary emboli, bleeding may
develop after thrombolytic therapy and fasciotomy should be initiated in
patients with extremity fractures without delaying nerve damage due to
compartment syndrome.    

Keywords

Thrombolytic therapy, compartment syndrome, Peroneal Nerve Paralysis

FİBULA FRAKTÜRÜNE BAĞLI GELİŞEN PULMONER EMBOLİ TEDAVİSİNDE TROMBOLİTİK UYGULAMASINA BAĞLI KOMPARTMAN SENDROMU

Abstract

Bu çalışmamızda; sol fibula
fraktürü sebebiyle takip altında iken pulmoner emboli gelişen ve trombolitik
tedavi başlanan fakat trombolitik tedaviye sekonder kruris anterolateral
kompartman sendromu gelişen vakamızı ve tedavisini sunmayı amaçladık. Özellikle
alt ekstremite fraktürlerinde immobilizasyona bağlı tromboembolik olaylar sık
görülmekte olup pulmoner emboli en korkulan komplikasyondur. Pulmoner emboli gelişen hastalarda trombolitik
tedavi sonrası kanama gelişebilir ve özellikle ekstremitede fraktürü olan
hastalarda kompartman sendromuna bağlı sinir hasarlarına karşı vakit
kaybetmeden fasyatomi açılmalıdır.

Keywords

Trombolitik tedavi, Kompartman sendromu, peroneal sinir hasarı

References

• 1. Kafadar H, Kafadar S. Pulmonary thromboembolism due to simple bone fracture in a young patient. A case report. J Clin Anal Med 2014: 1-3.
• 2. Altınbaş Ö, Çomaklı H. Deep vein thrombosis after sodium hyaluronate injection to knee joint: a case report. J Clin Anal Med 2018;9(5): 466-8.
• 3. Kadakal F, Çetinkaya E, Tıldız P ve ark. Klinik Olarak Yüksek Olasılıklı Pulmoner Emboli Olgularında Tanı. Solunum Hastalıkları 2000; 11: 140-143.
• 4. Shibuya N., Frost C.H., Campbell J.D., Davis M.L., Jupiter D.C. Incidences of acute deep vein thrombosis and pulmonary embolism in foot and ankle trauma: analysis of the National Trauma Data Bank. J Foot Ankle Surg. 2012;51:63–68.
• 5. Fiumara K, Kucher N, Fanikos J, Goldhaber SZ. Predictors of majör hemorrhage following fibrinolysis for acute pulmonary embolism. Am J Cardiol 2006;97:127-129.
• 6. Moyer RA, Boden BP, Marchetto PA, Kleinbart F, Kelly JD IV. Acute compartment syndrome of the lower extremity secondary to noncontact injury. Foot Ankle. 1993;14(9):534-537.
• 7. Tuna S, Duymuş TM, Mutlu S, Ketenci İE, Ulusoy A. Upper extremity acute compartment syndrome during tissue plasminogen activator therapy for pulmonary embolism in a morbidly obese patient. Int J Surg Case Rep. 2015; 8: 175–178.
• 8. Mueller M, Dunnet W. Acute on chronic peroneal compartment syndrome. Injury. 2004; 35(11):1196-1199.
• 9. Moyer RA, Boden BP, Marchetto PA, Kleinbart F, Kelly JD IV. Acute compartment syndrome of the lower extremity secondary to noncontact injury. Foot Ankle. 1993;14(9):534-537.
• 10. Jameson S.S., Augustine A., James P. Venous thromboembolic events following foot and ankle surgery in the english national health service. J Bone Jt Surg (Br) 2011;93-B:490–497.