Thigh compartment syndrome, presentation and complications.

Area of Science:

• Trauma Surgery
• Orthopaedic Surgery
• Vascular Surgery

Background:

• Thigh compartment syndrome (TCS) is a rare but severe condition resulting from elevated pressure within the thigh, potentially leading to tissue necrosis and systemic complications.
• It affects a small percentage of trauma patients (0.3%) but carries significant risks, including infection, amputation, renal insufficiency, and death.

Purpose of the Study:

• To detail the patient demographics, causes, and complications of thigh compartment syndrome.
• To analyze treatment outcomes for TCS patients at a Level 1 trauma center.

Main Methods:

• Retrospective cohort study analyzing nine consecutive patients with TCS over an eight-year period.
• Data collected included patient demographics, injury mechanisms, clinical findings, time to surgery, and complications.

Main Results:

• The study population consisted of young patients (average age 34.8 years), with vascular injury noted in 55.5%.
• A tense, edematous thigh was the most common clinical sign (77.8%). Average time to surgery was 19.8 hours, with 33% showing ischemic muscle changes upon release.
• Complications, including infection and amputation, occurred in 44.4% of patients.

Conclusions:

• TCS is associated with high-energy trauma and poses diagnostic challenges in obtunded or polytrauma patients.
• Prompt recognition and multidisciplinary management involving surgical, intensive care, and interventional radiology teams are essential to mitigate severe medical and legal consequences.