Compartment Syndrome Due to Massive Leg Hematoma After Primary Total Hip Arthroplasty: A Previously Unreported Complication of Fondaparinux

Abstract

Fondaparinux is an accepted form of deep venous thrombosis prophylaxis after hip arthroplasty. Cited advantages of its use include once-daily administration, standard dosage, and superiority as compared with enoxaparin. However, there have been several case reports of serious associated bleeding complications. We describe the case of a 77-year-old woman who developed a massive leg hematoma in the operative extremity nearly 3 weeks after a primary total hip arthroplasty while on fondaparinux. The patient developed a compartment syndrome requiring decompression of the hematoma, fasciotomy, and subsequent additional plastic surgery for split thickness skin grafting.