Graduation Year

2018

Embargo Period

3-21-2020

Document Type

Research Paper

Degree Name

Medical Doctor (MD)

Department

Orthopaedic Surgery

First Advisor

Tae Won B. Kim, MD

Subject(s)

Medical Research, Surgery

Abstract

Gluteal compartment syndrome (GCS) is a rare surgical emergency where ischemic changes occur to the gluteal muscles from an increase in compartment pressure. While the condition is rare, it is associated with significant risk of high morbidity and mortality. The purpose of this systematic review of the literature was to compile and review the current evidence of the causes, treatments, and outcomes of GCS.

This systematic review was performed at a level-one trauma center and was an institutional review board-exempt study. EmBase, Ovid, and PubMed databases were searched for case reports and series of gluteal compartment syndrome. The publications were reviewed and analyzed to identify the causes and conditions that lead to GCS.

Our review identified two major mechanisms leading to GCS: iatrogenic and non-iatrogenic. Iatrogenic mechanisms included prolonged immobilization due to decreased sensation following surgery with spinal anesthesia, intraoperative hypoperfusion during surgical procedures, intraoperative positioning, bone marrow biopsy complications, prolonged immobilization due to intubation postoperatively, gluteal morphine injection, and statin-induced myositis. Noniatrogenic mechanisms included prolonged immobilization secondary to substance abuse, trauma, and over-exertion.

We reported on the clinical outcomes associated with regard to mechanism and treatment, discussed different types of fasciotomy incisions used in the treatment of GCS, delineated general recommendations for managing GCS, and identified areas for further research.

Available for download on Saturday, March 21, 2020

Share

COinS