Presence Of Compartment Syndrome Research Articles

Predictive factors for infection after osteosynthesis of tibial plateau fractures: a retrospective study of 314 patients.

The reported incidence of infection related with tibial plateau fractures (IRTPF) ranges from 2 to 23%. This complication can result in catastrophic consequences such as deformity, post-traumatic osteoarthritis, chronic pain, loss of function, and substantial economic burdens on healthcare systems due to extended hospital stays and the resources required for treatment. Consequently, it is imperative to emphasize the identification of infection risk factors. A retrospective case-control study was designed, encompassing patients who underwent surgery for tibial plateau fractures between 2015 and 2020. Frequencies and measures of central tendency were compared between infected patients (cases) and non-infected patients (controls) using rank-based statistical tests. Subsequently, two logistic regression models were employed to control for potential confounding variables. A total of 314 patients were included, predominantly male (71.15%). Average age of 44.41years. IRTPF were observed in 7.64% of the patients. In the univariate inferential statistical analysis, high-energy fractures (OR 6.35, p < 0.001), fractures with compartment syndrome (OR 7.10, p < 0.001), two-stage management with temporary external fixation (OR 8.18, p < 0.001), the use of 2 or more approaches in definitive surgery (OR 2.93, p = 0.011), and the use of two or more plates (OR 9.17, p < 0.001) were identified as risk factors for infection. On average, the duration of surgery in infected patients was 201.2min, compared to 148.4min in non-infected patients (p < 0.001). When performing two logistic regression models, the following independent risk factors were identified: high-energy fractures (OR 5.04, p = 0.012), the presence of compartment syndrome (OR 4.53, p = 0.007), and the use of two or more plates in definitive surgery (OR 5.04, p = 0.023). High-energy tibial plateau fractures (Schatzker IV, V, and VI), the presence of concomitant compartment syndrome, and the use of 2 or more plates in definitive surgery are associated with a higher risk of infection related to fracture following open reduction and osteosynthesis treatment. Case-Control Study.

Evaluation of musculoskeletal injuries after the 2023 Kahramanmaras earthquake: A local hospital experience.

The aim of this study was to evaluate musculoskeletal injuries, clinical follow-ups and treatments of trauma patients admitted to our hospital after the 2023 Kahramanmaras earthquake. Between February 6th, 2023 and February 16th, 2023, a total of 957 trauma patients (452 males, 505 females; mean age: 36.2±19.9 years; range, 0 to 97 years) who were affected by the earthquake were retrospectively analyzed. Age, sex, presence of orthopedic consultation, diagnosis of open/closed fracture, diagnosis of dislocation, presence and classification of soft tissue injury, additional system injury, preoperative and postoperative neurovascular examination status, presence of compartment syndrome, conservative/surgical applications, operation side, fasciotomy surgery and level, amputation surgery and level, length of stay in the hospital and intensive care unit (ICU), the Mangled Extremity Severity Score (MESS) score were collected. A total of 811 of the survivors were Turkish and 146 were Syrians. Of 957 earthquake victims, 40% had soft tissue injuries, 19% had closed fractures, 8.9% had other system injuries, 7.7% had crush injuries, 4.1% had nerve injuries, 2.1% had compartment syndrome, 2.1% had vascular injury, 1.8% had dislocation, and 1.7% had open fracture. Surgical or conservative treatments were applied to 574 patients with musculoskeletal injuries. Conservative treatment was applied to 322 of 574 patients and surgical procedure was applied to 252 patients. The highest patient density is experienced within the first 24 h after a devastating earthquake. The most common injuries due to high-energy trauma are isolated soft tissue injuries and fractures. The definition of the demographic characteristics and clinical outcomes of earthquake patients is critical to the development of preparedness, response, and recovery policies for future disasters..

Limb Fasciotomy for COVID-19 Patients: Is the Chance to Cut a Chance to Cure?

Summary:Based on the findings of two consecutive cases of upper extremity compartment syndrome encountered at our institution, we hypothesize that the presence of compartment syndrome in the unstable COVID-19 patient may be associated with high mortality and low limb salvage rates. A literature search was conducted with key search terms, including “compartment syndrome, fasciotomy, COVID, and coronavirus.” Articles describing patients with a confirmed COVID-19 diagnosis who developed extremity compartment syndrome were included in our study. The primary outcome investigated was patient survival. Secondary outcomes included limb survival and limb salvage. Limb salvage was calculated in patients who survived to time of discharge, whereas limb survival was counted for all patients. We then added our two cases to the findings reported in our literature to determine current overall limb salvage and patient survival rates. Our review of the literature yielded six case reports of ten extremities that developed compartment syndrome in the COVID-19 positive patient. Overall survival was four of six patients (67%). The overall limb survival rate at the time of hospital discharge was three of 10 (30%). With the addition of our two cases, overall survival was four of eight (50%) and overall limb survival rate was three of 12 (25%). Furthermore, with inclusion of our two cases, the patient survival rate of hemodynamically unstable patients was only three of seven (43%). The development of compartment syndrome in the unstable COVID-19 patient may be a harbinger of death, and the decision to proceed with operative intervention is challenging, complex, and in some cases must prioritize life over limb.

Risk Factors for Infection in Patients Undergoing Osteosynthesis for Tibial Plateau Fracture in a University Hospital.

Schatzker types IV to VI tibial plane fractures compromise the two tibial plateaus. Most cases involve joint deviation and require anatomic reduction and rigid fixation. Dual access and prolonged surgical time are factors that exert an influence on the occurrence of infection of the surgical wound and, consequently, the clinical outcome. The reason why these fractures have a greater incidence of infection compared to others remains unclear. The aim of the present study was to investigate risk factors for infection in patients undergoing osteosynthesis for tibial plateau fracture considering demographic, clinical, and operative factors.A retrospective study was conducted with data on patients with Schatzker types IV, V, and VI tibial plateau fracture submitted to surgical treatment at a tertiary university hospital affiliated with the public healthcare system. The following data were extracted from the patient files: age; type of fracture; mechanisms of trauma; exposure of fracture; use of external fixator prior to osteosynthesis considering the time of fixator use, distance between Schanz screws, and location of the fracture; presence of compartment syndrome; number of surgical accesses; surgical time; number of participants in surgery and smoking; and comparing groups with and without infection at the surgical site in the immediate postoperative period (up to three weeks). Among the 44 patients studied, mean age was 48.5±15.1 years, 72.7% patients were male, 11.4% were diabetic, 56.8% had Schatzker type V tibial fracture, 88.6% had fractures caused by high-impact trauma, 95.5% of the fractures were closed, 100% used an external fixator prior to definitive osteosynthesis, 54.5% had a single lateral surgical access, and infection at the surgical site occurred in 25% of patients. In the comparison of patients with and without infection, a significant difference was found regarding the distance between the Schanz screws and location of the fracture (p=0.0286), which was shorter in patients with infection at the surgical site. The analysis of potential risk factors for infection revealed that open fracture was the only risk factor in patients with proximal tibial fracture, with a 1.22-fold increase in the likelihood of infection (odds ratios {OR}: 1.22; 95% confidence intervals {CI}: 0.93-1.62; p=0.012). In conclusion, open fracture, greater proximity between the Schanz screws of the external fixator, and the location of the fracture were considered risk factors for infection at the surgical site in patients undergoing osteosynthesis for tibial plateau fracture.

Tactics of Surgical Treatment of Wounded with Gunshot Injuries of the Upper Limb in Modern Conditions

Summary. Our study aimed to optimize the tactics of surgical treatment of wounded with gunshot wounds of the upper extremity by determining the factors influencing the outcome of treatment of servicemen in modern conditions of specialized and highly specialized medical care.&#x0D; Materials and Methods. Surgical treatment of 123 patients with gunshot wounds of the upper extremity who were treated at the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine” and the National Military Medical Clinical Center “Main Military Clinical Hospital” of the Ministry of Defense of Ukraine was analyzed. The mean age of patients was (35.3±8.7). At the level III of medical care, the largest share was occupied by wound closure (28.0%) and surgeries on the skeletal system (6.7%). At the level IV of medical care, the largest share was occupied by surgical procedures for closing unhealed wounds – 28%, due to the consequences of gunshot nerve injuries – 11.5%, fractures – 10.7%, and restorative interventions on muscles – 5.5%.&#x0D; Results. By calculating the odds ratio (Odds Ratio, OR), it was found that the presence of compartment syndrome reduces the probability of obtaining a positive result by 11 times (OR=11.3), and late treatment at the level IV of care reduces the effectiveness of treatment by 9 times (OR=9.1). In the group of patients with peripheral nerve damage, satisfactory results were 6.9 times less than in the group without such damage (OR=6.9); the presence of a tissue defect worsened the prognosis of treatment by almost 5 times (OR=4.7). The average time to start surgical treatment after a gunshot wound was 2.8±5.0 days at the level III and 47.2±70.4 days at the level IV. It was found that for patients admitted to the level IV facilities for up to 30 days, the percentage increase in upper extremity function was 42.6±11.8 after treatment and 28.5±10.0 at a later start of treatment.&#x0D; Conclusions. The results of the study of the factors influencing the outcome of treatment prove the need for early (up to 3 weeks) admission of wounded with gunshot wounds to the level IV of medical care.

Predictors of compartment syndrome of the foot after fracture of the calcaneus

Category: Trauma Introduction/Purpose: Identifying predictors of compartment syndrome in the foot after a fracture of the calcaneus may lead to earlier diagnosis and treatment. The aim of our study was to identify any such predictors. Methods: We retrospectively reviewed 303 patients (313 fractures) with a fracture of the calcaneus who presented to us between October 2008 and September 2016. The presence of compartment syndrome and potential predictors were identified by reviewing their medical records. Potential predictors included age, gender, concomitant foot injury, mechanism of injury, fracture classification, time from injury to admission, underlying illness, use of anticoagulant/antiplatelet agents, smoking status and occupation. Associations with predictors were analyzed using logistic regression analysis Results: Of the 313 fractures of the calcaneus, 12 (3.8%) developed a compartment syndrome. A Sanders type IV fracture was the only strongly associated factor (odds ratio 21.67, p = 0.007). Other variables did not reach statistical significance. Conclusion: A Sanders type IV fracture is the best predictor of compartment syndrome after a fracture of the calcaneus.

Predictors of compartment syndrome of the foot after fracture of the calcaneus.

Identifying predictors of compartment syndrome in the foot after a fracture of the calcaneus may lead to earlier diagnosis and treatment. The aim of our study was to identify any such predictors. We retrospectively reviewed 303 patients (313 fractures) with a fracture of the calcaneus who presented to us between October 2008 and September 2016. The presence of compartment syndrome and potential predictors were identified by reviewing their medical records. Potential predictors included age, gender, concomitant foot injury, mechanism of injury, fracture classification, time from injury to admission, underlying illness, use of anticoagulant/antiplatelet agents, smoking status and occupation. Associations with predictors were analyzed using logistic regression analysis. Of the 313 fractures of the calcaneus, 12 (3.8%) developed a compartment syndrome. A Sanders type IV fracture was the only strongly associated factor (odds ratio 21.67, p = 0.007). Other variables did not reach statistical significance. A Sanders type IV fracture is the best predictor of compartment syndrome after a fracture of the calcaneus. Cite this article: Bone Joint J 2018;100-B:303-8.

Complications and revision amputation following trauma-related lower limb loss

IntroductionTrauma-related amputations are a common cause of limb loss in the United States. Despite the military and public health impact of trauma-related amputations, distributions of various lower limb amputations and the relative frequency of complications and revision amputations have not been well described. We used the National Trauma Data Bank (NTDB) in order to investigate the epidemiology of trauma-related lower extremity amputations among civilians in U.S. trauma centers. Materials and methodsWe conducted a secondary data analysis of the 2011–2012 NTDB research data sets, using means and frequencies to characterize the patient population and describe the distribution of major lower extremity amputations. Multivariable regression models were fit to identify predictors of major post-surgical complications, revision amputation, length of hospitalization, and in-hospital mortality. ResultsA total of 2879 patients underwent a major lower extremity amputation secondary to a trauma-related lower limb injury, representing 0.18% of all NTDB trauma admissions from 2011 to 2012. 80.4% were male and 67.6% were white. The three most frequent definitive amputations preformed included trans-tibial (46%), trans-femoral (37.5%), and through foot (7.6%). The average length of hospitalization for all amputees was 22.7days. Patients with at least one revision amputation stayed in the hospital approximately 5.5days longer than patients not needing a revision amputation. 1204 patients (41.8%) required at least one revision amputation. 27.5% of amputees experienced at least one major post-surgical complication. African Americans experienced a 49% higher major post-surgical complication incidence and stayed, on average, 2.5days longer in the hospital compared to whites. Injury severity score, age, hospital teaching status, presence of a crush injury, fracture location, presence of compartment syndrome, and experiencing a major post-surgical complication were all significant predictors of revision amputation. ConclusionWe report a high rate of complications and revision amputations among trauma-related lower limb amputees, and identify predictors of surgical outcomes that have not been described in the literature including African American race. Compartment syndrome is a significant predictor of major post-surgical complications, revision amputation, and length of hospitalization.

Risk factors for infection after operative fixation of Tibial plateau fractures

IntroductionTibial plateau fractures are challenging to treat due to the high incidence of postoperative infections. Treating physicians should be aware of risk factors for postoperative infection in patients who undergo operative fixation. Patients and methodsA retrospective review was undertaken to identify all patients with tibial plateau fractures over a 10 year period (2003–2012) who underwent open reduction internal fixation. A total of 532 patients were identified who met the inclusion criteria. Several patient and clinical characteristics were recorded, and those variables with a significant association (p<0.05) with postoperative infection after a univariate analysis were further analyzed using a multivariate analysis. ResultsFifty-nine (11.1%) of the 532 patients developed a deep infection. The average length of follow-up for patients was 19.5 months. Methicillin-resistant Staphylococcus aureus was the most common species, and it was isolated in 26 (44.1%) patients. Open fractures, the presence of compartment syndrome, and a Schatzker type IV−VI were found to be independent risk factors for deep infection. ConclusionsThe rate of deep infection remains high after operative fixation of tibial plateau fractures. Patients with risk factors for infection should be counseled on the possibility of reoperation, and surgeons should consider MRSA prophylaxis in those patients who are at higher risk.

Analysis of the characteristics of patients with open tibial fractures of Gustilo and Anderson type III

ObjectiveTo analyze the characteristics of patients with Gustilo–Anderson Type III open tibial fractures treated at a tertiary care hospital in São Paulo between January 2013 and August 2014. MethodsThis was a cross-sectional retrospective study. The following data were gathered from the electronic medical records: age; gender; diagnosis; trauma mechanism; comorbidities; associated fractures; Gustilo and Anderson, Tscherne and AO classifications; treatment (initial and definitive); presence of compartment syndrome; primary and secondary amputations; MESS (Mangled Extremity Severity Score) index; mortality rate; and infection rate. Results116 patients were included: 81% with fracture type IIIA, 12% IIIB and 7% IIIC; 85% males; mean age 32.3 years; and 57% victims of motorcycle accidents. Tibial shaft fractures were significantly more prevalent (67%). Eight patients were subjected to amputation: one primary case and seven secondary cases. Types IIIC (75%) and IIIB (25%) predominated among the patients subjected to secondary amputation. The MESS index was greater than 7 in 88% of the amputees and in 5% of the limb salvage group. ConclusionThe profile of patients with open tibial fracture of Gustilo and Anderson Type III mainly involved young male individuals who were victims of motorcycle accidents. The tibial shaft was the segment most affected. Only 7% of the patients underwent amputation. Given the current controversy in the literature about amputation or salvage of severely injured lower limbs, it becomes necessary to carry out prospective studies to support clinical decisions.

Análise das características dos pacientes com fratura exposta de tíbia grau III de Gustilo e Anderson

ObjectiveTo analyze the characteristics of patients with Gustilo‐Anderson Type III open tibial fractures treated at a tertiary care hospital in São Paulo between January 2013 and August 2014. MethodsThis was a cross‐sectional retrospective study. The following data were gathered from the electronic medical records: age; gender; diagnosis; trauma mechanism; comorbidities; associated fractures; Gustilo and Anderson, Tscherne and AO classifications; treatment (initial and definitive); presence of compartment syndrome; primary and secondary amputations; MESS (Mangled Extremity Severity Score) index; mortality rate; and infection rate. Results116 patients were included: 81% with fracture type IIIA, 12% IIIB and 7% IIIC; 85% males; mean age 32.3 years; and 57% victims of motorcycle accidents. Tibial shaft fractures were significantly more prevalent (67%). Eight patients were subjected to amputation: one primary case and seven secondary cases. Types IIIC (75%) and IIIB (25%) predominated among the patients subjected to secondary amputation. The MESS index was greater than 7 in 88% of the amputees and in 5% of the limb salvage group. ConclusionThe profile of patients with open tibial fracture of Gustilo and Anderson Type III mainly involved young male individuals who were victims of motorcycle accidents. The tibial shaft was the segment most affected. Only 7% of the patients underwent amputation. Given the current controversy in the literature about amputation or salvage of severely injured lower limbs, it becomes necessary to carry out prospective studies to support clinical decisions.

El cierre temporal de la cavidad abdominal: una revisión

As part of the treatment procedure when there is a risk or presence of compartment syndrome or serious intraabdominal infection, the abdominal cavity may need to be temporarily closed. Temporary abdominal closure may also be required during trauma surgery for a large abdominal wall defect or damage control. However, this procedure, although extremely useful, is not without complications and this has prompted the search for a technique that will somehow avoid or minimize the consequences of an open abdomen. In this paper, we review the state of the topic including different indications and methods used for both temporary and definitive closure of the fascia, and discuss their possible benefits or shortcomings.

Complications of high-energy bicondylar tibial plateau fractures treated with dual plating through 2 incisions.

To characterize the rate of complications after operative fixation of bicondylar (OTA/AO 41-C) tibial plateau fractures and to evaluate the contribution of common risk factors. Retrospective review. Level 1 regional trauma center. One hundred thirty-eight patients older than 18 years with 140 bicondylar tibial plateau fractures were participated in this study. Open reduction and internal fixation using medial and lateral plate construct through 2 incisions. Development of a deep infection or a nonunion. The overall major complication rate was 27.9%: 23.6% deep infection and 10.0% nonunion. Open fractures were associated with a higher rate of infection: 43.8% versus 21.0% for closed injuries (odds ratio = 2.96, P = 0.05). Fasciotomy closure before definitive fixation was associated with significantly fewer deep infections compared with internal fixation with open fasciotomy wounds: 11.8% versus 50.0% (odds ratio = 7.5, P = 0.05). The presence of compartment syndrome, tobacco use, diabetes, and timing of surgery had no statistically significant association on the rate of infection or nonunion. Nonunion and deep infections occur commonly after staged open reduction and internal fixation of high-energy tibial plateau fractures. Open fractures and open fasciotomy wounds at the time of internal fixation are associated with higher rates of infection. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Surgical site infection after open reduction and internal fixation of tibial plateau fractures

The aim of this study was to identify risk factors for surgical site infections and to quantify the contribution of independent risk factors to the probability of developing infection after definitive fixation of tibial plateau fractures in adult patients. A retrospective analysis was performed at a level I trauma center between January 2004 and December 2010. Data were collected from a review of the patient's electronic medical records. A total of 251 consecutive patients (256 cases) were divided into two groups, those with surgical site infections and those without surgical site infections. Preoperative and perioperative variables were compared between these groups, and risk factors were determined by univariate analyses and multivariate logistic regression. Variables analyzed included age, gender, smoking history, diabetes, presence of an open fracture, presence of compartment syndrome, Schatzker classification, polytrauma status, ICU stay, time from injury to surgery, use of temporary external fixation, surgical approach, surgical fixation, operative time, and use of a drain. The overall rate of surgical site infection after ORIF of tibial plateau fractures during the 7 years of this study was 7.8% (20 of 256). The most common causative pathogens was Staphylococcus aureus (n=15, 75%). Independent predictors of surgical site infection identified by multivariate analyses were open tibial plateau fracture (odds ratio=3.9; 95% CI=1.3-11.6; p=0.015) and operative time (odds ratio=2.7; 95% CI=1.6-4.4; p<0.001). The presence of compartment syndrome (odds ratio=3.4; 95% CI=0.7-15.9; p=0.119), use of temporary external fixation (odds ratio=0.5; 95% CI=0.2-1.7; p=0.298), and ICU stay (odds ratio=1.0; 95% CI=1.0-1.1; p=0.074) were not determined to be independent predictors of surgical site infection. Both open fracture and operative time are independent risks factors for postoperative infection.

Immediate Intramedullary Flexible Nailing of Open Pediatric Tibial Shaft Fractures

Flexible nailing has become the preferred implant for pediatric patients with tibial shaft fractures that require operative fixation. Immediate definitive fracture fixation with flexible nails in patients with high-energy, open fractures has not been examined. The purpose of our study was to determine if immediate flexible nailing of open pediatric tibial shaft fractures is safe and efficacious from a bone healing, wound, and infectious standpoint. A retrospective review of 26 tibial shaft fractures consecutively treated with flexible nailing at our institution from 2003 to 2010 was performed. Age, mechanism of injury, associated injuries, presence of compartment syndrome, antibiotic administration, systemic insults, time to union, as well as bone healing (nonunion, delayed union, malunion, leg length discrepancy, growth arrest), wound, and infectious complications were collected. Comparisons were made between patients with open fractures and those with closed fractures. We identified 14 patients with open fractures and a control group of 12 patients with closed injuries who underwent flexible nailing. Patients with open fractures were more likely to have polytraumatic injuries (71.0% vs. 25.0%, P = 0.04). There was no difference (P = 1.0) in the rates of compartment syndrome (open = 14.0%, closed = 17.0%) between the 2 groups. Systemic complications (pulmonary compromise and increased intracranial pressure) were noted in 2 patients who underwent immediate nailing of their open fractures; both of whom had closed head injuries. There was no difference (P = 1.0) in the rates of wound/infectious complications between the open (7.0%) and closed (4.0%) fractures groups, with no cases of wound breakdown or osteomyelitis. There was an increased rate (P = 0.02) of bone healing complications in the open fracture group (21.0% vs. 4.0%); all in patients with Gustilo type 2 or 3 injuries. All patients achieved radiographic union at final follow-up. Immediate flexible nailing of open pediatric tibial shaft fractures can be safely performed with minimal risk of wound or infectious complications. Clinicians should understand that prolonged bone healing (particularly in Gustilo type 2 or 3 injuries) should be expected in patients who undergo immediate flexible nailing of their open fractures. Open tibial shaft fractures are high-energy injuries, and should be seen as surrogate markers of polytrauma in the pediatric population. The risk of compartment syndrome is high regardless of whether a patient has a closed or open tibia fracture, and caution should be used in performing flexible nailing in patients who may have closed head injury due to a risk of systemic complications. Level III, therapeutic study, retrospective cohort.

Combined use of free and pedicled skin flaps for the reconstruction of extremities in high voltage electrical injury

Electrocution represents an uncommon but often severe cause of injury. Most of the incidents are work-related and the victims are mostly males. Hands and upper extremities are the main entrance site, while legs and feet are the grounding point. The size of the skin burn is usually circumscribed, but the wound is often deep, involving with progressive severity subcutaneous tissue, nerve, muscle and bone (iceberg lesion) [1,2]. Surgical treatment must be performed as soon as possible, as well as resuscitation therapy and management of systemic complications. Escharotomy and fasciotomy must be performed in case of circumferential injuries and/or in presence of compartment syndrome. Debridement of non-viable tissues must be performed early but avoiding sacrifice of tissues of questionable viability until complete demarcation of necrotic areas occurs. To protect the wound bed and the vital structures eventually present, appropriate skin substitutes are required. Finally reconstruction of the injured areas must be planned focusing attention on restoring complete function of the extremities involved [3–5].

Consecuencias del consumo de heroína: síndrome compartimental y rabdomiolisis

Compartment syndrome is a condition in which increased pressure within a limited space compromises tissue perfusion with the development of rhabdomyolysis. The causes can be physical, such as the pressure exerted on an anatomical region, or it can be associated with the consumption of illegal drugs, especially heroin. In this latter case, toxic and immunological mechanisms are involved in the physiopathology. Acute renal failure develops in 30% of cases of rhabdomyolysis. Its treatment includes efficient volume replacement, forcing urinary alkalinization and the administering of furosemide and mannitol, with certain precautions. No benefit has been shown in dopamine. When a heroin addict patient shows a clinical pattern of tumescence of his extremities, with or without a period of unconsciousness, the presence of compartment syndrome is to be suspected.

Weight Lifting as a Cause of Bilateral Upper Extremity Compartment Syndrome.

In brief: Compartment syndrome caused by weight lifting occurs only rarely. In the case presented here, bilateral upper extremity compartment syndrome with rhabdomyolysis developed in a 30-year-old man who was an experienced weight lifter. Compartment pressure of 31 mm Hg in his right and left biceps, combined with other clinical findings, indicated that fasciotomy was necessary. Bilateral fasciotomies were performed from the mid-deltoid muscle to the distal forearm. Six weeks later the patient had good muscle strength and full range of motion in both arms. In addition to the case report, the authors discuss the clinical findings that suggest the presence of compartment syndrome.