Combined Upper Extremity and Gluteal Compartment Syndrome Following Illicit Drug Abuse: A Retrospective Case Series

Abstract

Introduction

The purpose of this study was to describe four cases of patients who developed concomitant upper extremity and gluteal compartment syndrome in the context of substance abuse. In somnolent patients unable to provide a reliable physical exam, the healthcare provider must be aware of patients presenting with concomitant upper extremity and gluteal compartment syndrome.

Methods

Retrospective chart review identified cases of the combined upper extremity and gluteal compartment syndrome following illicit drug abuse at a single academic center during the years 2009–2019.

Results

During the 11-year period examined, a total of eight patients were diagnosed with compartment syndrome secondary to illicit drug use and prolonged immobilization. Four (50%) patients presented with combined upper extremity and gluteal compartment syndrome. All of these patients underwent prompt surgical release of the affected compartments. All eventually returned to normal activities of daily living.

Discussion

Compartment syndrome is primarily a clinical diagnosis, with physical exam being extremely important. In patients presenting with somnolence secondary to illicit drug use, physical exam may not be reliable. It is critical to have a high clinical suspicion in this patient population, understanding that these patients may present with concomitant upper extremity and gluteal compartment syndrome.

Level of Evidence

Level IV, case series.

Keywords:

• compartment syndrome
• fasciotomy
• trauma
• upper extremity
• gluteal

Acknowledgments

No support was received for this manuscript. Investigation performed at Columbia University Medical Center, New York, New York, USA.

Ethics Statement

This research study was authorized by the Columbia University Medical Center IRB, and has been performed in accordance with the principles stated in the Declaration of Helsinki.

Informed Consent Statement

Written informed consent was obtained from patients to publish case details and accompanying images.

Disclosure

The authors report no conflicts of interest in this work.