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Bilateral gluteal compartment syndrome following robotic-assisted prostatectomy.
MedLine Citation:
PMID:  21053878     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Bilateral gluteal compartment syndrome is a rare condition. Only 6 previous cases have been reported in the literature. Two previous cases involved positioning for urological procedures, while the other cited causes of bilateral gluteal compartment syndrome include exercise-induced, trauma, and prolonged immobilization from substance abuse. The 2 previously published reports of bilateral gluteal compartment syndrome associated with urologic positioning were treated conservatively due to late presentation and onset of rhabdomyolysis. This article presents a case of a 61-year-old man who developed bilateral gluteal compartment syndrome following prolonged urologic surgery in a dorsal lithotomy position. Orthopedic evaluation revealed physical examination findings and intracompartment pressures consistent with bilateral gluteal compartment syndrome. He underwent bilateral gluteal compartment fasciotomies. An expansile-type Kocher Langenbach incision was made, extending from lateral to the posterior superior iliac spine inferior to the level of the greater trochanter. The 3 compartments were decompressed bilaterally. At completion, the compartments showed definite objective softening. He was treated with delayed closure of his fasciotomy wounds. He was discharged home on sixth postoperative day 6. His wounds healed without difficulty and he regained normal strength and sensation in his lower extremities. Gluteal compartment syndrome following surgery is a preventable condition. Prevention should center on intraoperative padding and positioning, intraoperative repositioning, and restricting the length of the procedure. Once it is identified, early diagnosis and treatment can prevent long term complications.
Authors:
Roxanne Keene; John M Froelich; Joseph C Milbrandt; Osaretin B Idusuyi
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Publication Detail:
Type:  Journal Article     Date:  2010-11-02
Journal Detail:
Title:  Orthopedics     Volume:  33     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  852     Citation Subset:  IM    
Copyright Information:
Copyright 2010, SLACK Incorporated.
Affiliation:
Division of Orthopedics and Rehabilitation, Southern Illinois University School of Medicine, Springfield, Illinois, USA.
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