Atraumatic Posterior Thigh Compartment Syndrome Presenting as an Acute Sciatic Nerve Palsy. A Case Report

Document Type : CASE REPORT


1 Rothman Orthopaedic Institute, Philadelphia, PA, USA

2 Rowan University School of Osteopathic Medicine, Philadelphia, PA, USA


Atraumatic posterior thigh compartment syndrome is a rare but serious condition. We document a case of atraumatic
posterior thigh compartment syndrome that presented as an acute sciatic nerve palsy and required emergent fasciotomy.
Based on this case, one should keep in mind the diagnosis of posterior thigh compartment syndrome when encountering
a patient presenting with an acute sciatic nerve palsy.
Level of evidence: V


1. Mubarak SJ, Owen CA, Hargens AR, Garetto LP, Akeson
WH. Acute compartment syndromes. J Bone Joint
Surg. 1978; 60(8):1091-1095.
2. Boland MR, Heck C. Acute exercise-induced bilateral
thigh compartment syndrome. Orthopedics. 2009;
3. Ojike NI, Roberts CS, Giannoudis PV. Compartment
syndrome of the thigh: a systematic review. Injury.
2010; 41(2):133-6.
4. Schwartz Jr JT, Brumback RJ, Lakatos RO, Poka
AT, Bathon GH, Burgess AR. Acute compartment
syndrome of the thigh. A spectrum of injury. The
Journal of bone and joint surgery. American volume.
1989; 71(3):392-400.
5. Alobaidi A, Backdash MM, El‐Menyar A. Thigh
compartment syndrome complicated by sciatic nerve
palsy, rhabdomyolysis, and acute renal failure. Clinical
case reports. 2016; 4(2):107.
6. Mithoefer K, Lhowe DW, Vrahas MS, Altman DT,
Erens V, Altman GT. Functional outcome after acute
compartment syndrome of the thigh. JBJS. 2006;
7. Stracciolini A, Hammerberg M. Acute compartment
syndrome of the extremities. In: UpToDate, Post TW
(Ed), UpToDate, Waltham, MA. (Accessed on Feb 23,
8. Khan SK, Thati S, Gozzard C. Spontaneous thigh
compartment syndrome. Western Journal of
Emergency Medicine. 2011; 12(1):134.
9. Javedani PP, Ratnabalasuriar R, Grall KJ. Spontaneous
compartment syndrome of the thigh in the absence
of trauma. The Journal of emergency medicine. 2016;
10. Gutfraynd A, Philpott S. A case of acute atraumatic 
emergency medicine. 2016; 51(3):e45-7.
11. Pentz K, Triplet JJ, Johnson DB, Umbel B, Baker TE.
Nontraumatic Compartment Syndrome in a Patient
with Protein S Deficiency: A Case Report. JBJS Case
Connector. 2018; 8(4):e82.
12. Zimmerman JE, Afshar F, Friedman W, Miller CA.
Posterior compartment syndrome of the thigh with
a sciatic palsy: case report. Journal of neurosurgery.
1977; 46(3):369-72.
13. McQueen MM, Gaston P, Court-Brown CM. Acute
compartment syndrome: who is at risk? The Journal
of bone and joint surgery. British volume. 2000;
14. Bhalla MC, Dick-Perez R. Exercise induced
rhabdomyolysis with compartment syndrome and
renal failure. Case reports in emergency medicine.
2014; 2014.
15. Ferreira TA, Pensado A, Dominguez L, Aymerich
H, Molins N. Compartment syndrome with severe
rhabdomyolysis in the postoperative period
following major vascular surgery. Anaesthesia.
1996; 51(7):692-4.
16. Torres PA, Helmstetter JA, Kaye AM, Kaye AD.
Rhabdomyolysis: pathogenesis, diagnosis, and
treatment. Ochsner Journal. 2015; 15(1):58-69.
17. Keltz E, Khan FY, Mann G. Rhabdomyolysis. The role of
diagnostic and prognostic factors. Muscles, ligaments
and tendons journal. 2013; 3(4):303.
18. Brancaccio P, Lippi G, Maffulli N. Biochemical
markers of muscular damage. Clinical Chemistry and
Laboratory Medicine (CCLM). 2010; 48(6):757-67.
19. Khan FY. Rhabdomyolysis: A review of the literature.
Neth J Med. 2009; 67(9): 272-283
20. Elliott KG, Johnstone AJ. Diagnosing acute compartment
syndrome. The Journal of bone and joint surgery.
British volume. 2003; 85(5):625-32.
21. Reneman RS, Slaaf DW, Lindbom L, Tangelder GJ,
Arfors KE. Muscle blood flow disturbances produced
by simultaneously elevated venous and total muscle
tissue pressure. Microvascular research. 1980;
22. Whitesides TE, Heckman MM. Acute compartment
syndrome: update on diagnosis and treatment. JAAOSJournal
of the American Academy of Orthopaedic
Surgeons. 1996; 4(4):209-18.
23. Sauret JM, Marinides G, Wang GK. Rhabdomyolysis.
American family physician. 2002; 65(5):907.
24. Gabow PA, Kaehny WD, Kelleher SP. The Spectrum of
Rhabdomyolysis. Medicine. 1982; 61(3):141-152.
25. Melli G, Chaudhry V, Cornblath DR. Rhabdomyolysis.
Medicine. 2005; 84(6):377-385.
26. Bosch X, Poch E, Grau JM. Rhabdomyolysis and acute
kidney injury. New England Journal of Medicine.
2009; 361(1):62-72.
27. Ho KM, Power BM. Benefits and risks of furosemide
in acute kidney injury. Anaesthesia. 2010 Mar;
28. Crum-Cianflone NF. Bacterial, fungal, parasitic, and
viral myositis. Clinical Microbiology Reviews. 2008;
29. Tanaka T, Takada T, Takagi D, Takeyama N, Kitazawa
Y. Acute renal failure due rhabdomyolysis associated
with echovirus 9 infection. A case report and review
of literature. Japanese journal of medicine. 1989;
30. Agyeman P, Duppenthaler A, Heininger U, Aebi C.
Influenza-associated myositis in children. Infection.
2004; 32(4):199-203.