A compartment syndrome may develop in the thigh following a precipitating event. Prompt recognition and treatment can prevent long term complications.
Precipitating factors:
(1) blunt or penetrating trauma
(2) crush injury
(3) vascular injury or surgery, especially if both artery and vein are affected
(4) ischemia-reperfusion injury
(5) strenuous exercise
The presence of scarring from previous surgery or injury may increase the risk by limiting tissue expansion.
Clinical features:
(1) intense pain
(2) swelling
(3) elevated compartment pressure
(4) rhabdomyolysis with elevated serum CK and myoglobinuria
Muscle groups at risk:
(1) anterior (sartorius, rectus femoris, vastus lateralis, intermedius, medialis, articularis genu)
(2) lateral
Management:
(1) fasciotomy
(2) extensive debridement of necrotic muscle
(3) delayed wound closure
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Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
