Delayed Onset Compartment Syndrome Secondary to a Thigh Contusion in a Division 1 MenÍs Hockey Athlete: A Case Study

Abstract

Objectives: Present a case of delayed onset thigh compartment syndrome (DOTCS) secondary to a contusion in a collegiate athlete. Discuss the external factors, while informing health professionals of this injury and morbidity. æBackground: An athlete sustaining a thigh contusion had an increase in symptoms three days post-injury. Treatments applied during that time included deep oscillation therapy, intermittent pneumatic compression, ice, and compression. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) were ingested against advice. The patient was evaluated by a physician and transported for compartmental pressure measurements. æDifferential Diagnosis: Deep Vein Thrombosis, Hematoma, Acute Ischemia, Rabdomyolysis, Quadriceps Contusion, Compartment Syndrome, Myositis Ossificans. Treatments: The fasciotomy was performed when the athleteÍs compartmental pressure reached 61mmHg and was extended through the muscle to extract a hematoma. He was discharged after five days with clearance to bear weight as tolerable. æUniqueness: DOTCS secondary to a contusion is rare. Compartment syndrome of the anterolateral thigh is commonly a result of blunt trauma secondary to femoral fractures and car accidents. There was a reduction of edema and pain after the initial injury, then a sudden resurgence of symptoms three days post-injury. æConclusions: DOTCS can develop from a contusion. Healthcare professionals must use caution when blunt trauma is involved and should know the morbidity related to untreated cases. Future studies are necessary regarding the effects of pneumatic sequential compression and NSAIDs on the vascular system and compartment syndrome and on the influence of clinical outcomes to determine treatment protocols. æKey Words: Compartment syndrome, Hematoma, Intermittent Pneumatic Compression, NSAIDs, Fasciotomy, Contusion.