Deltoid Compartment Syndrome After Prolonged Lateral Decubitus Positioning

Abstract

Deltoid compartment syndrome can occur from operative positioning, with poor long-term outcomes as a result. Expeditious surgery, additional padding, and repeat checks are necessary for at-risk patients.

Complications of Lateral Decubitus Positioning During Orthopaedic Surgery

“…Although rare, several deltoid compartment syndrome cases have been reported with mixed etiologies 13 16 . In all 3 cases, the patients were ultimately taken to the operating room for emergency fasciotomy of the deltoid.…”

“…Wijesuriya et al reported a case of deltoid compartment syndrome complicated by anabolic steroid use in a 20-year-old man who underwent fixation of the contralateral distal humerus 15 . Borenstein et al published a case report of a 36-year-old man who underwent surgery for an open fracture of the distal left humerus who developed contralateral right deltoid compartment syndrome 16 . In all 3 cases, the patients were ultimately taken to the operating room for emergency fasciotomy of the deltoid.…”

Acute compartment syndrome of the contralateral thigh following reconstructive shoulder surgery done for multidirectional shoulder instability in lateral decubitus position

“…2 The occurrence of nontraumatic ACS in a well limb has been reported after various types of orthopaedic and general surgeries that were prolonged and were done in various positions, including supine, prone, lithotomy, hemilithotomy, tuck, knee-chest and lateral decubitus (also known as 'lateral position'). [1][2][3][4][5][6][7][8] We report the case of a healthy patient who developed ACS of the thigh after a 7-hour shoulder surgery that was done in the lateral decubitus position. Table 1 lists cases found in our literature review (PubMed and Google) where ACS occurred in a well limb after diverse types of surgeries done in the lateral decubitus position (without use of a tourniquet 9 ).…”

“…This complication is usually the result of patient positioning and prolonged surgery 2. The occurrence of non-traumatic ACS in a well limb has been reported after various types of orthopaedic and general surgeries that were prolonged and were done in various positions, including supine, prone, lithotomy, hemilithotomy, tuck, knee-chest and lateral decubitus (also known as ‘lateral position’) 1–8…”

“…Obtained from various sources 2–4 6 7 40–43F, female; LLD, left lateral decubitus; M, male; NA, not available/not known; RLD, right lateral decubitus.…”