Lower extremity compartment syndrome

Cone, Jennifer; Inaba, Kenji

doi:10.1136/tsaco-2017-000094

Cited by 56 publications

(48 citation statements)

References 50 publications

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“… 22 Considering the lack of certainty when assessing muscle viability especially in the acute setting, it is recommended to reexamine at a planned second look within 24–48 hours from the initial operation. 23 This result was echoed in our patients, as all patients required multiple surgical debridements.…”

Section: Discussionsupporting

confidence: 60%

Combined Upper Extremity and Gluteal Compartment Syndrome Following Illicit Drug Abuse: A Retrospective Case Series

Königsberg¹,

Mueller²,

Lebovic³

et al. 2020

ORR

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Introduction:The purpose of this study was to describe four cases of patients who developed concomitant upper extremity and gluteal compartment syndrome in the context of substance abuse. In somnolent patients unable to provide a reliable physical exam, the healthcare provider must be aware of patients presenting with concomitant upper extremity and gluteal compartment syndrome. Methods: Retrospective chart review identified cases of the combined upper extremity and gluteal compartment syndrome following illicit drug abuse at a single academic center during the years 2009-2019. Results: During the 11-year period examined, a total of eight patients were diagnosed with compartment syndrome secondary to illicit drug use and prolonged immobilization. Four (50%) patients presented with combined upper extremity and gluteal compartment syndrome. All of these patients underwent prompt surgical release of the affected compartments. All eventually returned to normal activities of daily living. Discussion: Compartment syndrome is primarily a clinical diagnosis, with physical exam being extremely important. In patients presenting with somnolence secondary to illicit drug use, physical exam may not be reliable. It is critical to have a high clinical suspicion in this patient population, understanding that these patients may present with concomitant upper extremity and gluteal compartment syndrome. Level of Evidence: Level IV, case series.

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Section: Discussionsupporting

confidence: 60%

Combined Upper Extremity and Gluteal Compartment Syndrome Following Illicit Drug Abuse: A Retrospective Case Series

Königsberg¹,

Mueller²,

Lebovic³

et al. 2020

ORR

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show abstract

“…The symptoms and signs of gluteal compartment syndrome can be aided by labs and imaging to rule out other causes of the presenting symptoms. Creatine kinase and potassium levels are often elevated due to muscle ischemia [ 19 ]. Thus, given the large muscle mass involved, it is likely that a rise in CK may be one of the signs of compartment syndrome.…”

Section: Discussionmentioning

confidence: 99%

Missed positional gluteal compartment syndrome in an obese patient after foot surgery: a case report

et al. 2020

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Background Gluteal compartment syndrome is an uncommon condition and can be difficult to diagnose. It has been diagnosed after trauma, vascular injury, infection, surgical positioning, and prolonged immobilization from drug or alcohol intoxication. The diagnosis is based on clinical findings and, in most cases, recognizing these symptoms and making a diagnosis early is critical to a complete recovery. Case presentation A 53-year-old male who underwent left foot surgery had severe pain to his contralateral hip and posterior gluteal compartment radiating to the right lower extremity immediately postoperative. He was positioned supine with a “bump” placed under his right hip to externally rotate his operative leg during the surgery. Due to the patient’s complex past medical history, a presumptive diagnosis of a herniated disc and/or compression of the sciatic nerve was made as a cause for the patient’s pain. This resulted in a misdiagnosis period of 36 h until the patient was diagnosed with unilateral gluteal compartment syndrome. Performing a fasciotomy was decided against due to the increased risk of complications. The patient was treated with administration of IV fluids and closely monitored. On post-op day 6, the patient was discharged. At three months post-op, the patient was walking without a limp and he had no changes in his peripheral neurologic examination compared to his preoperative baseline. Conclusion Gluteal compartment syndrome is a surgical emergency that must be considered postoperatively especially in obese patients with prolonged operation times who experience acute buttock pain. The use of positional bars or “bumps” in the gluteal area should be used with caution and raise awareness of this complication after orthopedic surgeries.

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“…Any pressure exceeding 30 mmHg indicates compartment syndrome. [12] If the clinical findings are suggestive of compartment syndrome, compartment pressure measurement should be done immediately to confirm or exclude the diagnosis. The treatment is emergent fasciotomy of all involved compartments.…”

Section: Discussionmentioning

confidence: 99%

Compartment syndrome secondary to Baker's cyst rupture: A case report and up-to-date review

Erkuş

Soyarslan

Köse

et al. 2019

Int J Crit Illn Inj Sci

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Baker's cyst is a distention or enlargement of the gastrocnemius-semimembranosus bursa toward the popliteal fossa which is usually associated with intra-articular pathologies. Rupture or dissection of the Baker's cyst results in extravasation of the cyst content into the calf within intermuscular space under the fascia. This clinical entity, also called pseudothrombophlebitis, is a self-limited condition that usually resolves with supportive treatment. However, in patients using anticoagulants, excessive hemorrhage may cause compartment syndrome in case of cyst rupture. Early diagnosis of compartment syndrome is the most important step in preventing permanent disability. Therefore, compartment syndrome should be kept in mind and ruled out in a patient with pseudothrombophlebitis syndrome under anticoagulation therapy.

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Lower extremity compartment syndrome

Cited by 56 publications

References 50 publications

Combined Upper Extremity and Gluteal Compartment Syndrome Following Illicit Drug Abuse: A Retrospective Case Series

Combined Upper Extremity and Gluteal Compartment Syndrome Following Illicit Drug Abuse: A Retrospective Case Series

Missed positional gluteal compartment syndrome in an obese patient after foot surgery: a case report

Compartment syndrome secondary to Baker's cyst rupture: A case report and up-to-date review

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