Papageorgiou Platon, Giannatos Vasileios, Antzoulas Panagiotis, Argyropoulou Evangelia, Koukos Christos, Kokkalis Zinon
Department of Orthopedic Surgery and Trauma, University Hospital of Patras, Patras, Greece.
Department of Orthopedic Surgery and Trauma, Sports Trauma Pain and Arthroscopy Institute of Thessaloniki, Thessaloniki, Greece.
Am J Case Rep. 2025 Sep 21;26:e948893. doi: 10.12659/AJCR.948893.
BACKGROUND Compartment syndrome is a serious condition characterized by increased interstitial pressure within a closed osseofascial compartment, which can result from decreased compartment volume, increased contents, or external pressures. Gluteal and thigh compartment syndrome, although rare, is linked to severe local complications such as tissue necrosis, infection, and even amputation, as well as systemic issues like renal failure and, in some cases, death. Prompt recognition and treatment are essential for improving outcomes, as delays significantly raise the risk of adverse and potentially life-threatening consequences. Acute gluteal compartment syndrome often results from prolonged pressure due to immobilization and can be associated with collapse caused by alcohol or drug abuse. CASE REPORT A 30-year-old male intravenous drug user (IVDU) was admitted with severe pain, swelling, and motor deficits in the right thigh and gluteal region due to prolonged immobilization during loss of consciousness from drug use. Examination revealed sciatic nerve palsy. Magnetic resonance imaging (MRI) showed swelling of the gluteal and posterior thigh muscles along with fluid collection. Emergency fasciotomy and sciatic nerve release were performed through a posterior approach. Postoperatively, the patient experienced rapid improvement in neurological function and mobility. CONCLUSIONS Our findings underscore the importance of maintaining a high index of suspicion among immobilized patients, especially intravenous drug users who may remain unconscious for extended periods, crushing parts of their bodies. Early recognition and intervention are vital for preventing severe complications associated with this condition. This case highlights the need for increased awareness and proactive management when treating IVDUs presenting with severe pain in the gluteal or thigh region and acute sciatic nerve palsy.
骨筋膜室综合征是一种严重的病症，其特征是封闭的骨筋膜室内的组织间压力升高，这可能由骨筋膜室容积减小、内容物增加或外部压力引起。臀肌和大腿骨筋膜室综合征虽然罕见，但与严重的局部并发症如组织坏死、感染甚至截肢有关，也与肾衰竭等全身问题有关，在某些情况下还会导致死亡。及时识别和治疗对于改善预后至关重要，因为延误治疗会显著增加不良后果和潜在危及生命后果的风险。急性臀肌骨筋膜室综合征通常由固定体位导致的长时间压迫引起，并且可能与酒精或药物滥用导致的虚脱有关。
一名30岁的男性静脉吸毒者因吸毒导致意识丧失期间长时间固定体位，出现右大腿和臀肌区域严重疼痛、肿胀及运动功能障碍而入院。检查发现坐骨神经麻痹。磁共振成像（MRI）显示臀肌和大腿后部肌肉肿胀并伴有积液。通过后路进行了急诊筋膜切开术和坐骨神经松解术。术后，患者的神经功能和活动能力迅速改善。
我们的研究结果强调了对固定体位患者，尤其是可能长时间昏迷并压迫身体某些部位的静脉吸毒者，保持高度怀疑指数的重要性。早期识别和干预对于预防与此病症相关的严重并发症至关重要。该病例突出了在治疗出现臀肌或大腿区域严重疼痛及急性坐骨神经麻痹的静脉吸毒者时，提高认识和积极管理的必要性。
