J Korean Fract Soc.  2006 Jan;19(1):89-92. 10.12671/jkfs.2006.19.1.89.

Spontaneous Intramuscular Hematoma associated with Acute Compartment Syndrome after Treatment of Low Molecular Weight Heparin: A Report of Two Cases

• Kim KW
• Nam WD
• Rhyu KH
• Cho BR
• Kim YH
• Awe SI

• KMID: 2063830
• DOI: http://doi.org/10.12671/jkfs.2006.19.1.89

Abstract

Low-molecular-weight heparin (LMWH) has been considered superior to unfractionated heparin in several facets such as more effective anticoagulant, more predictable bioavailability, and less bleeding complications. We report two cases of LMWH, enoxaparin-induced spontaneous intramuscular hematoma with compartment syndrome of the lower extremity in patients with cardiac problems. The patients were treated with enoxaparin (LMWH) as bridging anticoagulation before use of warfarin due to cardiac problems. At the average 3 days of enoxaparin treatment, large and painful swelling was noticed in the lower extremities without intramuscular injection or trauma. The patients were diagnosed as having compartment syndrome with large intramuscular hematoma by CT. The patients underwent immediate fasciotomy and hematoma evacuation, and recovered without any complications.

Keyword

Intramuscular hematoma; Compartment syndrome; Low-molecular-weight heparin; Fasciotomy; Complication

MeSH Terms

Biological Availability
Compartment Syndromes*
Enoxaparin
Hematoma*
Hemorrhage
Heparin
Heparin, Low-Molecular-Weight*
Humans
Injections, Intramuscular
Lower Extremity
Warfarin
Enoxaparin
Heparin
Heparin, Low-Molecular-Weight
Warfarin