Traumatic subcutaneous emphysema of the hand/forearm: A case report

作     者：Stephen Saela Alexander Decilveo Roman Isaac Deepak V.Patel Stephen Saela;Alexander Decilveo;Roman Isaac;Deepak V. Patel

作者机构：Department of Orthopaedic SurgerySt Josephs University Medical CenterPatersonNJ 07503USA Department of Orthopaedic SurgerySeton Hall UniversitySouth OrangeNJ 07079US 

出 版 物：《Chinese Journal of Traumatology》 (中华创伤杂志（英文版）)

年 卷 期：2022年第25卷第6期

页      面：395-399页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Upper extremity Traumatic subcutaneous emphysema Sucking-wounds Penetrating Necrotizing fasciitis Case reports Laboratory Risk Indicator for Necrotizing Fasciitis(LRINEC) 

摘      要：Subcutaneous emphysema is commonly associated with infection caused by gas-producing *** this case report,we describe a rare instance of traumatic subcutaneous emphysema of the hand and forearm caused by a puncture injury to the first web space of the *** objective is to increase awareness of the potential for seemingly minor trauma to cause entrapment of significant air in subcutaneous tissues,thereby decreasing the likelihood that a clinically benign-appearing patient will be started down an unnecessarily aggressive treatment pathway.A 16-year-old,otherwise healthy white female,presented to the pediatric emergency room with an impressive amount of subcutaneous emphysema that developed over a 12-h period after sustaining an accidental laceration to the first web space of her right *** appeared nontoxic and had a clinically benign presentation.A comprehensive work-up was *** was splinted by the orthopedic surgery resident on call,and was admitted to the Pediatric Intensive Care Unit for overnight *** received tetanus vaccination and broad-spectrum *** patient was discharged 2 days after admittance,with a splint applied to her right hand and *** undertook home-based physical and occupational *** had a pain-free range-of-motion in the right wrist,elbow and *** swelling in the right hand subsided *** initially alarming,traumatic subcutaneous emphysema in an otherwise healthy patient from minor wounds(as featured in this case)does not necessarily mean one ought to proceed down an aggressive treatment *** evaluation of the patient s history,clinical examination findings,and determination of the Laboratory Risk Indicator for Necrotizing Fasciitis score can help guide physicians in the management of traumatic subcutaneous emphysema and potentially avoid unnecessary and costly interventions.