scholarly journals Gluteal Compartment Syndrome Secondary to Pelvic Trauma

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Fernando Diaz Dilernia ◽  
Ezequiel E. Zaidenberg ◽  
Sebastian Gamsie ◽  
Danilo E. R. Taype Zamboni ◽  
Guido S. Carabelli ◽  
...  
Keyword(s):  
Physical Examination ◽  
Compartment Syndrome ◽  
Drug Users ◽  
Pelvic Ring ◽  
Pelvic Trauma ◽  
Intracompartmental Pressure ◽  
Permanent Disability ◽  
Delay In Diagnosis ◽  
Prolonged Immobilization ◽  
Gluteal Compartment Syndrome

Gluteal compartment syndrome (GCS) is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death.

scholarly journals Gluteal Compartment Syndrome After Prolonged Immobilization in Drug Abusers

Cureus ◽  
2020 ◽  
Author(s):  
Anupam K Gupta ◽  
Monica I Burgos ◽  
Miguel Lopez-Viego ◽  
Nir Hus
Keyword(s):  
Compartment Syndrome ◽  
Drug Abusers ◽  
Prolonged Immobilization ◽  
Gluteal Compartment Syndrome

scholarly journals Missed positional gluteal compartment syndrome in an obese patient after foot surgery: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Rami Khalifa ◽  
Madison R. Craft ◽  
Aaron J. Wey ◽  
Ahmed M. Thabet ◽  
Amr Abdelgawad
Keyword(s):  
Compartment Syndrome ◽  
Alcohol Intoxication ◽  
Complete Recovery ◽  
Clinical Findings ◽  
Herniated Disc ◽  
Foot Surgery ◽  
Presumptive Diagnosis ◽  
Increased Risk ◽  
Prolonged Immobilization ◽  
Gluteal Compartment Syndrome

Abstract Background Gluteal compartment syndrome is an uncommon condition and can be difficult to diagnose. It has been diagnosed after trauma, vascular injury, infection, surgical positioning, and prolonged immobilization from drug or alcohol intoxication. The diagnosis is based on clinical findings and, in most cases, recognizing these symptoms and making a diagnosis early is critical to a complete recovery. Case presentation A 53-year-old male who underwent left foot surgery had severe pain to his contralateral hip and posterior gluteal compartment radiating to the right lower extremity immediately postoperative. He was positioned supine with a “bump” placed under his right hip to externally rotate his operative leg during the surgery. Due to the patient’s complex past medical history, a presumptive diagnosis of a herniated disc and/or compression of the sciatic nerve was made as a cause for the patient’s pain. This resulted in a misdiagnosis period of 36 h until the patient was diagnosed with unilateral gluteal compartment syndrome. Performing a fasciotomy was decided against due to the increased risk of complications. The patient was treated with administration of IV fluids and closely monitored. On post-op day 6, the patient was discharged. At three months post-op, the patient was walking without a limp and he had no changes in his peripheral neurologic examination compared to his preoperative baseline. Conclusion Gluteal compartment syndrome is a surgical emergency that must be considered postoperatively especially in obese patients with prolonged operation times who experience acute buttock pain. The use of positional bars or “bumps” in the gluteal area should be used with caution and raise awareness of this complication after orthopedic surgeries.

scholarly journals Gluteal compartment syndrome caused by traumatic rupture of the superior gluteal artery

2016 ◽  
Vol 7 (1) ◽  
Author(s):  
Djemil Omerović ◽  
Ismet Gavrankapetanović ◽  
Faris Gavrankapetanović ◽  
Amel Hadžimehmedagić ◽  
Faruk Lazović ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Ct Scan ◽  
Compartment Syndrome ◽  
Gold Standard ◽  
Pelvic Trauma ◽  
Traumatic Rupture ◽  
Pubic Ramus ◽  
Superior Gluteal Artery ◽  
Gluteal Compartment Syndrome ◽  
Prompt Diagnosis

Introduction. We report a case of a sixty-year-old man diagnosed with glutealcompartment syndrome caused by traumatic rupture of the superior glutealartery associated with fracture of the inferior pubic ramus and blunt trauma.Case report. A patient was injured falling from a height of four meters. Signsof compartment syndrome and sciatic nerve compression developed threehours after the injury. The patient went through a computerized tomography(CT) scan procedure with contrast, which showed a hematoma in the glutealregion, but without signs of active bleeding. However, after observation andmonitoring of the patient, CT angiography was performed which revealeda rupture of the superior gluteal artery. Fasciotomy and debridement wereperformed and the patient was diagnosed with gluteal compartment syndromeand rupture of the superior gluteal artery. Surgery resulted in a significantimprovement of the patient’s condition.Conclusion. Traumatic gluteal compartment syndrome is a rare condition.Gluteal compartment syndrome should be taken into consideration in eachpatient with pelvic trauma and hematoma in the gluteal region whose neurologicalstatus is affected. Prompt diagnosis and fasciotomy are crucial inthe treatment and fasciotomy presents the gold standard in the treatment.

scholarly journals Atraumatic Gluteal Compartment Syndrome Presenting in a Young Female with Unilateral Lower Extremity Symptoms

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Morgan Maxon ◽  
Curt Cackovic
Keyword(s):  
Lower Extremity ◽  
Compartment Syndrome ◽  
Kidney Injury ◽  
Rare Condition ◽  
Young Female ◽  
Delay In Diagnosis ◽  
Presenting Symptoms ◽  
Left Lower Extremity ◽  
Gluteal Compartment Syndrome ◽  
Drug And Alcohol

Gluteal compartment syndrome is a rare condition that often develops following immobilization either secondary to illicit drug and alcohol abuse or improper surgical positioning. A case of a 22-year-old female with left lower extremity pain, weakness, and numbness after prolonged stasis from a night of drug and alcohol use is presented. She also complained of left low back pain. Her initial neurologic examination was significant for decreased deep tendon reflexes, decreased motor strength, and decreased sensation in the left lower extremity. Severe pain in the affected region persisted despite several attempts at pain control utilizing multiple modalities. An emergent MRI of the lumbar spine revealed gluteal compartment syndrome. The patient ultimately underwent emergent fasciotomy with resultant improvement in neurologic symptoms. Because presenting symptoms are frequently nonspecific in initial stages, gluteal compartment syndrome is often misdiagnosed. This can lead to unnecessary morbidity and mortality. It is important to maintain a high index of suspicion for gluteal compartment syndrome because delay in diagnosis can lead to nerve palsy, acute kidney injury, sepsis, and/or death.

scholarly journals Application of Pelvic Circumferential Compression Devices in Pelvic Ring Fractures—Are Guidelines Followed in Daily Practice?

2021 ◽  
Vol 10 (6) ◽  
pp. 1297
Author(s):  
Valerie Kuner ◽  
Nicole van Veelen ◽  
Stephanie Studer ◽  
Bryan Van de Wall ◽  
Jürgen Fornaro ◽  
...  
Keyword(s):  
Clinical Education ◽  
Trauma Center ◽  
Pelvic Ring ◽  
Daily Practice ◽  
Pelvic Trauma ◽  
Fracture Pattern ◽  
Pelvic Fractures ◽  
Unstable Fracture ◽  
Associated Injuries ◽  
Resuscitation Room

Early administration of a pelvic circumferential compression device (PCCD) is recommended for suspected pelvic trauma. This study was conducted to evaluate the prevalence of PCCD in patients with pelvic fractures assigned to the resuscitation room (RR) of a Level I trauma center. Furthermore, correct application of the PCCD as well as associated injuries with potential clinical sequelae were assessed. All patients with pelvic fractures assigned to the RR of a level one trauma center between 2016 and 2017 were evaluated retrospectively. Presence and position of the PCCD on the initial trauma scan were assessed and rated. Associated injuries with potential adverse effects on clinical outcome were analysed. Seventy-seven patients were included, of which 26 (34%) had a PCCD in place. Eighteen (23%) patients had an unstable fracture pattern of whom ten (56%) had received a PCCD. The PCCD was correctly placed in four (15%) cases, acceptable in 12 (46%) and incorrectly in ten (39%). Of all patients with pelvic fractures (n = 77, 100%) treated in the RR, only one third (n = 26, 34%) had a PCCD. In addition, 39% of PCCDs were positioned incorrectly. Of the patients with unstable pelvic fractures (n = 18, 100%), more than half either did not receive any PCCD (n = 8, 44%) or had one which was inadequately positioned (n = 2, 11 %). These results underline that preclinical and clinical education programs on PCCD indication and application should be critically reassessed.

scholarly journals Factors Predicting Lower Leg Chronic Exertional Compartment Syndrome in a Large Population

2017 ◽  
Vol 39 (01) ◽  
pp. 58-66 ◽  
Author(s):  
Johan de Bruijn ◽  
Aniek van Zantvoort ◽  
David van Klaveren ◽  
Michiel Winkes ◽  
Marike van der Cruijsen-Raaijmakers ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Predictive Model ◽  
Pressure Measurement ◽  
Large Population ◽  
Lower Leg ◽  
Leg Pain ◽  
Intracompartmental Pressure ◽  
Discriminative Ability ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome

AbstractKnowledge about lower leg chronic exertional compartment syndrome (CECS) is largely obtained from highly selected populations. Patient characteristics may therefore not be appropriate for the general population. Our purpose was to describe a heterogeneous population of individuals suspected of lower leg CECS and to identify predictors of CECS. Charts of individuals who were analyzed for exercise-induced lower leg pain in a referral center between 2001 and 2013 were retrospectively studied. Patients were included if history and physical examination were suggestive of CECS and if they had undergone a dynamic intracompartmental pressure measurement. Six hundred ninety-eight of 1411 individuals were diagnosed with CECS in one or more of three lower leg muscle compartments (anterior tibial, deep flexor, lateral). Prevalence of CECS peaked around the age of 20–25 years and decreased thereafter, although a plateau around 50 years was found. Age, gender, bilateral symptoms, previous lower leg pathology, sports (running and skating) and tender muscle compartments were identified as independent predictors of lower leg CECS. The proposed predictive model has moderate discriminative ability (AUC 0.66) and good calibration over the complete range of predicted probabilities. The predictive model, displayed as a nomogram, may aid in selecting individuals requiring an invasive dynamic intracompartmental muscle pressure measurement.

Complete Bilateral Brachial Plexus Injury from Rhabdomyolysis and Compartment Syndrome: Surgical Case Report

2018 ◽  
Vol 17 (2) ◽  
pp. E68-E72 ◽  
Author(s):  
Daniel A Tonetti ◽  
Ivan S Tarkin ◽  
Kiran Bandi ◽  
John J Moossy
Keyword(s):  
Brachial Plexus ◽  
Compartment Syndrome ◽  
Clinical Presentation ◽  
Brachial Plexus Injury ◽  
Laboratory Data ◽  
Surgical Decompression ◽  
Sensory Function ◽  
Resonance Imaging ◽  
Pectoralis Muscles ◽  
Prolonged Immobilization

Abstract BACKGROUND AND IMPORTANCE Acute bilateral brachial plexus injury is rare and usually a result of traction injury. Immediate operative intervention is reserved for rare cases of ongoing compression of the plexus; the role for acute decompression of the brachial plexus secondary to compartment syndrome has not been previously described. In this report, we describe the technique and role for urgent brachial plexus decompression. CLINICAL PRESENTATION A 32-yr-old man presented with acute complete bilateral brachial plexus palsy due to focal rhabdomyolysis and brachial plexus compression after a night of excess alcohol and methadone ingestion. He had complete loss of motor and sensory function from C5 to T1, with the exception of partial sensory sparing of the C5 dermatome. Magnetic resonance imaging demonstrated diffuse muscular edema of the supraclavicular and infraclavicular fossae in addition to the pectoralis muscles and the deltoids bilaterally. He underwent urgent surgical decompression of his supraclavicular and infraclavicular fossae with fasciotomies of the pectoral muscles and the anterior deltoids, allowing direct visualization and decompression of the entire brachial plexus resulting in a near-complete functional recovery. CONCLUSION Neurosurgeons should include brachial plexus compression due to compartment syndrome in the differential diagnosis of patients with acute upper extremity weakness, particularly when associated with prolonged immobilization and/or substance abuse. Prompt surgical decompression should be performed in these patients if imaging and laboratory data suggest compartment syndrome and resultant neurological deficit.

scholarly journals Surgical Hemostasis for Severe Multisystem Pelvic Injuries

2020 ◽  
Vol 8 (4) ◽  
pp. 396-408
Author(s):  
I. V. Kazhanov ◽  
A. Y. Demko ◽  
V. A. Manukovsky ◽  
S. I. Mikityuk ◽  
V. A. Reva ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
Anterior Part ◽  
Treatment Algorithm ◽  
Pelvic Trauma ◽  
Balloon Occlusion ◽  
The Body ◽  
Military Surgery ◽  
Transfusion Therapy ◽  
Homogeneous Groups ◽  
Military Medical Academy

For the treatment of patients with severe multysistem pelvic trauma accompanied by pelvic bleeding, many algorithms have been proposed that have different procedures for the use of various methods of surgical hemostasis, but none of them may guarantee the complete arrest of pelvic bleeding. The purpose of this study was to estimate clinical efficacy and developed algorithm, aimed at timely diagnosis of intrapelvic bleeding and its complete arrest with the help of different methods of surgical hemostasis in patients with severe concomitant injury of the pelvis. The article analyzes the results of treatment of 168 patients with unstable pelvic ring injuries and signs of intrapelvic bleeding, who were treated in two trauma centers of the first level in St. Petersburg: I.I. Dzhanelidze St. Petersburg Research Institute of Emergency Medicine and Military Surgery Clinic of S.M. Kirov Military Medical Academy in 2010-2018. The victims were divided into two statistically homogeneous groups. In the comparison group (75 people), the pelvic ring was mechanically stabilized with the Ganz C-clamp or the anterior part of the pelvis was fixed with an external fixation device (EFD), and the arrest of the ongoing pelvic bleeding was expected due to occur due to the effect of biological tamponade. In the main group (93 people), after mechanical stabilization of the pelvic ring, various methods of surgical hemostasis were used: balloon occlusion of the aorta, pelvic tamponade, angiography with embolization. The choice of method for surgical haemostasis after trauma depended on the severity of the affected condition of hemodynamic parameters, availability of life-threatening consequences of damage to other areas of the body and the efficacy of previously applied method for intrapelvic bleeding arrest. The introduction of modern diagnostic and treatment algorithm, aimed at complete hemostasis in patients with ongoing intrapelvic bleeding reduced the overall mortality rate by 1.7 times, mortality within 24 hours of admission by 2.3 times, as well as the duration and the volume of blood transfusion therapy by 3 and 1.8 times.Authors declare lack of the conflicts of interests.

scholarly journals A Pain in the Butt: A Case Series of Gluteal Compartment Syndrome

2021 ◽  
Vol 2 (5) ◽  
pp. 144-147
Author(s):  
Jessica Jackson ◽  
Kraftin Schreyer
Keyword(s):  
Compartment Syndrome ◽  
Clinical Presentation ◽  
Case Series ◽  
Morbidity And Mortality ◽  
Emergency Physicians ◽  
Laboratory Findings ◽  
Diagnosis And Management ◽  
Gluteal Compartment Syndrome

Introduction: Gluteal compartment syndrome is a rare and difficult-to-diagnose form of compartment syndrome. Case Series: We present three patients with gluteal compartment syndrome and review the clinical presentation, imaging, and laboratory findings that assist in diagnosis. Suggestions for more readily diagnosing gluteal compartment syndrome are provided. Conclusion: Emergency physicians must be familiar with the diagnosis and management of gluteal compartment syndrome to prevent the significant associated morbidity and mortality.

scholarly journals Delayed Presentation of Gluteal Compartment Syndrome: The Argument for Fasciotomy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
John E. Lawrence ◽  
Duncan J. Cundall-Curry ◽  
Kuldeep K. Stohr
Keyword(s):  
Compartment Syndrome ◽  
Kidney Injury ◽  
Limb Ischaemia ◽  
Delayed Presentation ◽  
Neurological Improvement ◽  
Tertiary Centre ◽  
Acute Limb Ischaemia ◽  
Nerve Recovery ◽  
The Right ◽  
Gluteal Compartment Syndrome

A male patient in his fifties presented to his local hospital with numbness and weakness of the right leg which left him unable to mobilise. He reported injecting heroin the previous morning. Following an initial diagnosis of acute limb ischaemia the patient was transferred to a tertiary centre where Computed Tomography Angiography was reported as normal. Detailed neurological examination revealed weakness in hip flexion and extension (1/5 on the Medical Research Council scale) with complete paralysis of muscle groups distal to this. Sensation to pinprick and light touch was globally reduced. Blood tests revealed acute kidney injury with raised creatinine kinase and the patient was treated for rhabdomyolysis. Orthopaedic referral was made the following day and a diagnosis of gluteal compartment syndrome (GCS) was made. Emergency fasciotomy was performed 56 hours after the onset of symptoms. There was immediate neurological improvement following decompression and the patient was rehabilitated with complete nerve recovery and function at eight-week follow-up. This is the first documented case of full functional recovery following a delayed presentation of GCS with sciatic nerve palsy. We discuss the arguments for and against fasciotomy in cases of compartment syndrome with significant delay in presentation or diagnosis.

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