Hip Pelvis.  2012 Jun;24(2):160-163. 10.5371/hp.2012.24.2.160.

Acute Gluteal Compartment Syndrome without Gluteal Hematoma: A Case Report

• Kim KK
• Won YY
• Yi JW
• Lee JB
• Kim DY
• Jo IH

• KMID: 1439106
• DOI: http://doi.org/10.5371/hp.2012.24.2.160

Abstract

Acute gluteal compartment syndrome (AGCS) is a rare condition associated with trauma, drug abuse, alcohol intoxication, prolonged immobilization, hip arthroplasty and epidural anesthesia. We report the case of a 42-year-old woman presenting severe buttock pain following decreased lower extremity motor function after an incident whereby she rolled down a flight of stairs. We performed fasciotomy of the gluteal fascia in order to provide relief from acute gluteal compartment syndrome. At the 2 month follow up visit her sensory and motor function had improved. Acute gluteal compartment syndrome is a rare condition which can result in misdiagnosis or delayed diagnosis. Careful consideration is needed for patients suffering severe buttock pain.

Keyword

Acute gluteal compartment syndrome; Sciatic nerve; Fasciotomy

MeSH Terms

Adult
Anesthesia, Epidural
Arthroplasty
Buttocks
Compartment Syndromes
Delayed Diagnosis
Diagnostic Errors
Fascia
Female
Follow-Up Studies
Hip
Humans
Immobilization
Lower Extremity
Sciatic Nerve
Stress, Psychological
Substance-Related Disorders

Figure

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  Fig. 1 (A) Preoperative range of motion of ankle dorsiflexion (Grade 0). (B) Preoperative range of motion of great toe dorsiflexion (Grade 0).

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  Fig. 2 Preoperative magnetic resonance image of hip; High signal intensity at obturator externus/internus, quadratus femoris, gluteus maximus/medius/minimus, adductor brevis/minimus, pectineus muscles with overlying subcutaneous edema, left.

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  Fig. 3 Intraoperative finding; Subcutaneus edema and fluid collection between iliotibial tract and proximal femur.

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  Fig. 4 (A) 2 Weeks after Postoperative day; flexion and extension of great toe,ankle was recovered patially (Grade 4), (B) 3 Weeks after Postoperative day; Motor function was nearly full recovered (Grade 4+).

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