Date of Presentation

5-2-2019 12:00 AM

Embargo Period

11-2-2019

College

School of Osteopathic Medicine

Poster Abstract

Compartment syndrome(CS) occurs when intra-compartmental pressures exceeds to a point where arterial, venous and lymphatic circulation of local tissues, muscles and nerves is compromised. CS is most common after a traumatic injury and usually occurs in the leg or forearm and less commonly in the thigh. Thigh compartment syndrome is rare due to its larger size and more compliant borders. We present a case of nontraumatic compartment syndrome in the posterior thigh associated with rhabdomyolysis and a sciatic nerve palsy which then required emergent fasciotomy. The patient's course was further complicated by acute renal failure due to the rhabdomyolysis and thus required hemodialysis during the hospital stay. At four week follow up after the initial procedure, the patient no longer needed dialysis and had no pain in his left leg but felt weak secondary to muscle atrophy. The incision was completely healed and sensation was equal and symmetric to the opposite side. The EHL was rated as a 5-/5 and all other muscles in the leg were rated 5/5. Based on this case, it is important to consider the diagnosis of posterior thigh compartment syndrome when encountering a patient with acute sciatic nerve palsy. Additionally, the case highlights the importance of early recognition and management of CS and rhabdomyolysis so as to avoid potential disastrous outcomes of end stage kidney disease, limb amputation or death.

Keywords

compartment syndrome, nontraumatic, rhabdomyolysis, sciatic nerve palsy

Disciplines

Cardiovascular Diseases | Hemic and Lymphatic Diseases | Medicine and Health Sciences | Nephrology | Orthopedics | Pathological Conditions, Signs and Symptoms | Surgery

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May 2nd, 12:00 AM

A Case of Atraumatic Posterior Thigh Compartment Syndrome

Compartment syndrome(CS) occurs when intra-compartmental pressures exceeds to a point where arterial, venous and lymphatic circulation of local tissues, muscles and nerves is compromised. CS is most common after a traumatic injury and usually occurs in the leg or forearm and less commonly in the thigh. Thigh compartment syndrome is rare due to its larger size and more compliant borders. We present a case of nontraumatic compartment syndrome in the posterior thigh associated with rhabdomyolysis and a sciatic nerve palsy which then required emergent fasciotomy. The patient's course was further complicated by acute renal failure due to the rhabdomyolysis and thus required hemodialysis during the hospital stay. At four week follow up after the initial procedure, the patient no longer needed dialysis and had no pain in his left leg but felt weak secondary to muscle atrophy. The incision was completely healed and sensation was equal and symmetric to the opposite side. The EHL was rated as a 5-/5 and all other muscles in the leg were rated 5/5. Based on this case, it is important to consider the diagnosis of posterior thigh compartment syndrome when encountering a patient with acute sciatic nerve palsy. Additionally, the case highlights the importance of early recognition and management of CS and rhabdomyolysis so as to avoid potential disastrous outcomes of end stage kidney disease, limb amputation or death.

 

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