Bilateral simultaneous traumatic upper arm compartment syndromes associated with anabolic steroids.

Area of Science:

• Trauma Surgery
• Orthopedics
• Sports Medicine

Background:

• Acute compartment syndrome (ACS) is a surgical emergency characterized by elevated pressure within an osseofascial compartment.
• Reduced capillary perfusion in ACS necessitates urgent fasciotomy to prevent muscle and nerve ischemia, infarction, and contractures.

Observation:

• A 25-year-old male bodybuilder with a history of anabolic steroid use presented after a road traffic accident.
• He sustained bilateral upper limb injuries, including distal humerus fractures, with no initial distal neurovascular deficits.
• Within two hours, clinical signs of bilateral upper arm acute compartment syndrome emerged.

Findings:

• The patient developed acute compartment syndrome in both upper limbs following bilateral distal humerus fractures.
• Bilateral fasciotomies of the anterior and posterior compartments were performed, confirming the diagnosis.
• The patient's anabolic steroid use was a notable factor in his presentation.

Implications:

• Clinicians should inquire about anabolic steroid use in patients with extremity trauma, especially those presenting with signs of compartment syndrome.
• Anabolic steroids may be an underrecognized risk factor for developing acute compartment syndrome after trauma.
• Early recognition and surgical intervention (fasciotomy) are critical for favorable outcomes in acute compartment syndrome.