Bilateral Compartment Syndrome of the Thigh in a College Football Athlete: A Case Report.

Abstract

Whereas acute compartment syndrome is a well-described entity in the leg and forearm, compartment syndrome of the thigh is a much less common phenomenon secondary to the increased compartment compliance of the thigh and the potential for extravasation into the gluteal compartment1-5. The first report of acute compartment syndrome of the thigh attributed to prolonged limb ischemia was presented by Mubarak and Owen in 19756. The first reports of exercise-induced acute compartment syndrome of the thigh are attributed to Kmen et al. (1990)7 and Kahan et al. (1994)1. To date, the diagnosis of acute compartment syndrome of the thigh remains primarily clinical, with measurement of intracompartmental pressures being reserved for patients who are difficult to examine, who are intubated, who are in a comatose state, or who have equivocal findings on physical examination. Additionally, whereas the treatment of acute compartment syndrome of the leg and forearm is well established, the treatment of acute compartment syndrome of the thigh remains controversial. We report the case of a college football athlete who presented with rhabdomyolysis and acute bilateral compartment syndrome of the thigh with secondary acute kidney failure following a strength-training workout. The patient required emergent bilateral three-compartment fasciotomy. The patient discussed in this report was informed that data concerning his case were to be submitted for publication, and he agreed. The patient’s confidentiality was protected according to the Health Insurance Portability and Accountability Act. A twenty-two-year-old otherwise healthy black college football player presented to the emergency department of a level-I tertiary-care center approximately sixty hours after participating in a rigorous strength-training session. The session included a focus on lower-body strength training, and the patient stated that, in addition to the standard workout, he performed 100 squats with use of 280-lb (127-kg) weights. …