Thigh compartment syndrome in urban trauma: Bullets to blame, not collisions

Lawrence M. Knab, Adel Abuzeid, Heron Rodriguez, Nabil Issa

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background: Compartment syndrome of the thigh is a surgical emergency rarely reported in the literature. The most common etiologies include blunt trauma, vascular injuries from penetrating trauma, and hematoma formation. Thigh compartment syndrome (TCS) is important as it is often associated with concomitant severe injury with mortality rates as high as 47%. This study aims to identify mechanisms of injury, clinical presentation, and outcomes associated with TCS in the urban trauma patient population. Methods: Demographic and clinical information for all patients with a diagnosis of TCS at a level 1 urban trauma center over a 10.5-y period were reviewed. Collected data included age, sex, mechanism of injury, method of diagnosis, time taken for diagnosis and management, methods of decompression, wound management, lengths of stay in the intensive care unit and hospital, amputation rate, and hospital disposition. Results: Ten patients were identified with diagnosis of TCS. The mechanism of injury was penetrating in six patients and blunt in four. The mean time from injury to diagnosis was 23.4 h. Intensive care unit and hospital lengths of stay were significantly increased among patients sustaining penetrating injuries compared with blunt injuries. Two of the six penetrating injury patients underwent an amputation. Eight of 10 patients were ambulatory on discharge. There were no mortalities. Conclusions: Among urban trauma patients, penetrating injuries of the thigh and adjacent vascular structures and the need for decompressive fasciotomy of the lower leg are the major risk factors for TCS. Clinical diagnosis and early intervention with fasciotomy remain the mainstay of treatment.

Original languageEnglish (US)
Pages (from-to)748-752
Number of pages5
JournalJournal of Surgical Research
Issue number2
StatePublished - Dec 2013


  • Compartment syndrome
  • Penetrating injury
  • Thigh
  • Trauma

ASJC Scopus subject areas

  • Surgery


Dive into the research topics of 'Thigh compartment syndrome in urban trauma: Bullets to blame, not collisions'. Together they form a unique fingerprint.

Cite this