Gluteal Compartment Syndrome After Femoral Nail Extraction: A Case Report

Area of Science:

• Orthopedics
• Nephrology
• Surgical Complications

Background:

• Gluteal compartment syndrome (GCS) is a rare condition with no established treatment.
• Fasciotomy is the typical surgical approach, but conservative management has shown limited success.
• Obesity and prolonged surgical times are potential risk factors.

Observation:

• A 26-year-old obese male (BMI 40.5) developed severe buttock pain and lower extremity numbness post-femoral nail extraction.
• Symptoms progressed to include lower extremity muscle weakness and worsening renal function.
• Orthopedic and MRI findings confirmed gluteal compartment syndrome.

Findings:

• Conservative treatment, including temporary dialysis, was initiated due to diagnostic delays.
• The patient showed recovery of renal function and muscle strength.
• Discharge occurred on postoperative day 37, with full recovery of pain-free ambulation and neurological function at six months.

Implications:

• Highlights the potential for conservative management of gluteal compartment syndrome, especially with dialysis.
• Emphasizes the importance of considering GCS in obese patients with prolonged surgery experiencing acute buttock pain.
• Stresses the need for early diagnosis to ensure favorable patient outcomes and prevent complications.