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Acute exercise-induced bilateral thigh compartment syndrome.
1Department of Orthopedic Surgery, University of Kentucky College of Medicine, Lexington, Kentucky 40536, USA.
Orthopedics
|March 25, 2009
Summary
Severe bilateral thigh compartment syndrome after vigorous exercise is rare but can occur. Prompt fasciotomies are recommended over observation to prevent severe morbidity.
Area of Science:
- Orthopedics
- Sports Medicine
- Trauma Surgery
Background:
- Acute compartment syndrome (ACS) of the thigh is uncommon due to anatomical factors allowing for fluid accommodation.
- Vigorous physical activity can precipitate ACS, even in individuals without predisposing conditions.
Observation:
- A 29-year-old male presented with bilateral thigh pain and myoglobinuria following intense basketball activity.
- Physical examination revealed elevated compartment pressures (left: 80/75 mm Hg; right: 45/50 mm Hg) and pain on passive stretch.
- The patient developed significant left-sided motor and sensory neurological deficits.
Findings:
- Bilateral emergent anterior and posterior fasciotomies were performed to decompress the thigh compartments.
- The patient experienced partial recovery of neurological function in the left leg over six months.
- Ambulation with an ankle-foot orthosis was achieved at six-month follow-up.
Implications:
- This case highlights that severe exercise-induced ACS can occur in the thigh.
- Early surgical intervention with fasciotomies is crucial for managing exercise-induced ACS to mitigate neurological damage.
- Observation alone may lead to severe, long-term morbidity in cases of undertreated compartment syndrome.
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