J Korean Fract Soc.  2012 Jul;25(3):215-218.

Acute Compartment Syndrome of the Thigh Caused by Contusion: 4 Cases Report

• Shon OJ
• Kim GB
• Park CH

Abstract

Acute compartment syndrome of the thigh, which usually occurs in the anterior compartment, is a rare condition. It can have various causes including femur fractures, vessel injury, pseudoaneurysm of the femoral or popliteal artery, and use of anticoagulant. However, there have been few reports of acute compartment syndrome of the thigh without fracture caused by blunt trauma. We report 4 cases of acute compartment syndrome of the thigh without fracture caused by blunt trauma, in which three patients were treated with fasciotomy and a Vacuum-Assisted wound Closure system and the other one had a delayed diagnosis, and eventually underwent above-knee amputation.

Keyword

Thigh; Acute compartment syndrome; Fasciotomy; VAC systems

MeSH Terms

Amputation
Aneurysm, False
Compartment Syndromes
Delayed Diagnosis
Femur
Glycosaminoglycans
Humans
Popliteal Artery
Thigh
Glycosaminoglycans

Figure

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  Fig. 1 Pre-operative radiographs show soft tissue swelling without fracture around the distal femur.

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  Fig. 2 (A) Photograph taken postoperatively shows decompressive fasciotomy using a single-incision technique on the left lateral thigh. Photographs taken 3 days (B) and 7 days post-operatively (C) show reduced soft tissue swelling. (D) Photograph taken 10 days post-operatively shows delayed wound closure.

Reference

1. Burns BJ, Sproule J, Smyth H. Acute compartment syndrome of the anterior thigh following quadriceps strain in a footballer. Br J Sports Med. 2004. 38:218–220.

2. Gorman PW, McAndrew MP. Acute anterior compartmental syndrome of the thigh following contusion. A case report and review of the literature. J Orthop Trauma. 1987. 1:68–70.

3. Mithoefer K, Lhowe DW, Vrahas MS, Altman DT, Erens V, Altman GT. Functional outcome after acute compartment syndrome of the thigh. J Bone Joint Surg Am. 2006. 88:729–737.

4. Mithöfer K, Lhowe DW, Vrahas MS, Altman DT, Altman GT. Clinical spectrum of acute compartment syndrome of the thigh and its relation to associated injuries. Clin Orthop Relat Res. 2004. (425):223–229.

5. Rööser B, Bengtson S, Hägglund G. Acute compartment syndrome from anterior thigh muscle contusion: a report of eight cases. J Orthop Trauma. 1991. 5:57–59.

6. Suzuki T, Moirmura N, Kawai K, Sugiyama M. Arterial injury associated with acute compartment syndrome of the thigh following blunt trauma. Injury. 2005. 36:151–159.

7. Ulmer T. The clinical diagnosis of compartment syndrome of the lower leg: are clinical findings predictive of the disorder? J Orthop Trauma. 2002. 16:572–577.

8. Viegas SF, Rimoldi R, Scarborough M, Ballantyne GM. Acute compartment syndrome in the thigh. A case report and a review of the literature. Clin Orthop Relat Res. 1988. (234):232–234.

9. Whitesides TE, Haney TC, Morimoto K, Harada H. Tissue pressure measurements as a determinant for the need of fasciotomy. Clin Orthop Relat Res. 1975. (113):43–51.