Acute Anterior Thigh Compartment Syndrome Revisited: A Case Report and Review of Literature

Abstract

We present a rare case of acute anterior compartment syndrome of the thigh in a rugby player with no history of trauma during the game. Decompressive fasciotomy with subsequent closure of the wound resulted in good outcome. Acute compartment syndrome of the thigh should be suspected following vigorous exercise and fasciotomy is to be performed on urgent basis.

Acute anterior thigh compartment syndrome in Premiership rugby

“…Occurrences of ACS within sport are rare 2 10. There is a paucity of examples associated with the anterior thigh2 4–7 and none previously of a professional rugby player which have been published within empirical research. Commonly, previously published cases investigate ACS from a mechanical12 and clinical perspective.…”

“…Commonly, ACS aetiology is associated with compartments of the lower leg and forearm (with or without fractures) following direct trauma 2. However, isolated occurrences to the thigh have been noted2 4–7; even though the thigh contains a larger compartment encapsulated with dilative fascia and the anatomy of the hip naturally facilitates tissue expansion 8. Alternatively, instances of ACS have also been induced by exercise, known as exercise-induced compartment syndrome 9.…”

“…Alternatively, instances of ACS have also been induced by exercise, known as exercise-induced compartment syndrome 9. Athletes may be considered at higher risk of ACS as muscular hypertrophy and increased exercise tissue perfusion9 may reduce the available space within compartments 7 10. In combination with the physical demand and contact nature of sport, this may contribute to sports being the second most common cause for ACS developing 10…”

“…All known ACS occurrences within professional rugby have arisen in the previous 2 years, which have included this subject, All Black Prop Atu Moli and 2019 world player of the year Springbok Pieter-Steph du Toit. However, there have been semiprofessional instances prior to this 2 7 12…”