Thigh compartment syndrome after acute ischemia

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Orthopedic Surgery

Background:

• Thigh compartment syndrome (TCS) is a serious condition often overlooked, typically arising after reperfusion of ischemic thigh muscles.
• The anterior thigh compartment is particularly vulnerable due to its anatomical structure.
• Untreated TCS can lead to severe complications, including muscle death, myoglobinuria, and kidney failure.

Observation:

• A case of TCS developed in a patient treated for a gunshot wound to the thigh with associated vascular injuries.
• The patient presented with severe thigh pain, swelling, and elevated compartment pressures postoperatively.
• Despite surgical repair of some vessels, ligation of damaged profunda femoris vein branches contributed to the condition.

Findings:

• Surgical intervention, including lateral thigh fasciotomy and debridement of necrotic muscle, was performed.
• Delayed wound closure was utilized in the management of the patient's condition.
• The patient achieved a full recovery following the comprehensive treatment approach.

Implications:

• Physicians must be aware of various clinical scenarios, particularly trauma and physical activity, that can precipitate TCS.
• Early diagnosis and intervention are critical for preserving limb function and patient life.
• Irreparable damage to the profunda femoris vein can exacerbate the severity of thigh compartment syndrome.