Suspected gluteal compartment syndrome: Etiology predicts clinical course, outcomes and resource utilization
Background: Gluteal Compartment Syndrome (GCS) is a rare subtype of acute compartment syndrome (ACS), complex to diagnose and potentially fatal if left untreated. The incidence of ACS is estimated to be 7.3 per 100,000 in males and 0.7 per 100,000 in females [1–3]. Given its rare occurrence, the inc...
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Elsevier
2024-06-01
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| Series: | Trauma Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352644024000402 |
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| author | Alicia M. Williams Suman Medda Meghan K. Wally Rachel B. Seymour Alexander Hysong Amber Stanley Givenchy Manzano Joseph R. Hsu |
| author_facet | Alicia M. Williams Suman Medda Meghan K. Wally Rachel B. Seymour Alexander Hysong Amber Stanley Givenchy Manzano Joseph R. Hsu |
| author_sort | Alicia M. Williams |
| collection | DOAJ |
| description | Background: Gluteal Compartment Syndrome (GCS) is a rare subtype of acute compartment syndrome (ACS), complex to diagnose and potentially fatal if left untreated. The incidence of ACS is estimated to be 7.3 per 100,000 in males and 0.7 per 100,000 in females [1–3]. Given its rare occurrence, the incidence of GCS is not well reported. In the case of GCS, the most common etiologies are surgical positioning, prolonged immobilization secondary to substance use or loss of consciousness, and traumatic injury. Clinical findings are pulselessness, pallor, parasthesia, paralysis, and most notably pain out of proportion. Swift diagnosis and treatment are imperative to reduce morbidity and mortality, however the ideal management of GCS is difficult to ascertain given the rare occurrence and variable presentation. Methods: Orthopaedic trauma database at a level 1 trauma center was reviewed to identify patients for whom the orthopaedic service was consulted due to suspicion of gluteal compartment syndrome. This yielded 11 patients between 2011 and 2019. Patients with a measured ΔP greater than 30 upon initial consultation and with a concerning exam requiring monitoring were included. Patient demographics, comorbidities, GCS etiology, laboratory values, physical exam findings, pain scores (0−10) and patient outcomes were collected via chart review. Patient demographic and injury characteristics were summarized using descriptive statistics. Results: Prolonged immobilization patients had worse outcomes including longer hospital stays (40.5 days) compared to trauma patients (4.5 days). All adverse medical outcomes recorded including acute renal failure, prolonged neuropathic pain, cardiopulmonary dysfunction were exclusively experienced by prolonged immobilization patients. Conclusions: Our descriptive study demonstrates the bimodal distribution of GCS patients based on etiology. Prolonged immobilization patients have a longer hospital course and more complications. Our study confirms prior reports and provides information that can be used to counsel patients and families appropriately about treatment and recovery following GCS. Level of evidence: IV. Study type: Epidemiological. |
| format | Article |
| id | doaj-art-e02366f84eae44ff80b096ff5a6f8d07 |
| institution | OA Journals |
| issn | 2352-6440 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj-art-e02366f84eae44ff80b096ff5a6f8d072025-08-20T02:31:44ZengElsevierTrauma Case Reports2352-64402024-06-015110101710.1016/j.tcr.2024.101017Suspected gluteal compartment syndrome: Etiology predicts clinical course, outcomes and resource utilizationAlicia M. Williams0Suman Medda1Meghan K. Wally2Rachel B. Seymour3Alexander Hysong4Amber Stanley5Givenchy Manzano6Joseph R. Hsu72001 Vail Ave, Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC 28207, USACorresponding author at: 2001 Vail Ave, Charlotte, NC 28207, USA.; 2001 Vail Ave, Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC 28207, USA2001 Vail Ave, Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC 28207, USA2001 Vail Ave, Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC 28207, USA2001 Vail Ave, Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC 28207, USA2001 Vail Ave, Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC 28207, USA2001 Vail Ave, Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC 28207, USA2001 Vail Ave, Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC 28207, USABackground: Gluteal Compartment Syndrome (GCS) is a rare subtype of acute compartment syndrome (ACS), complex to diagnose and potentially fatal if left untreated. The incidence of ACS is estimated to be 7.3 per 100,000 in males and 0.7 per 100,000 in females [1–3]. Given its rare occurrence, the incidence of GCS is not well reported. In the case of GCS, the most common etiologies are surgical positioning, prolonged immobilization secondary to substance use or loss of consciousness, and traumatic injury. Clinical findings are pulselessness, pallor, parasthesia, paralysis, and most notably pain out of proportion. Swift diagnosis and treatment are imperative to reduce morbidity and mortality, however the ideal management of GCS is difficult to ascertain given the rare occurrence and variable presentation. Methods: Orthopaedic trauma database at a level 1 trauma center was reviewed to identify patients for whom the orthopaedic service was consulted due to suspicion of gluteal compartment syndrome. This yielded 11 patients between 2011 and 2019. Patients with a measured ΔP greater than 30 upon initial consultation and with a concerning exam requiring monitoring were included. Patient demographics, comorbidities, GCS etiology, laboratory values, physical exam findings, pain scores (0−10) and patient outcomes were collected via chart review. Patient demographic and injury characteristics were summarized using descriptive statistics. Results: Prolonged immobilization patients had worse outcomes including longer hospital stays (40.5 days) compared to trauma patients (4.5 days). All adverse medical outcomes recorded including acute renal failure, prolonged neuropathic pain, cardiopulmonary dysfunction were exclusively experienced by prolonged immobilization patients. Conclusions: Our descriptive study demonstrates the bimodal distribution of GCS patients based on etiology. Prolonged immobilization patients have a longer hospital course and more complications. Our study confirms prior reports and provides information that can be used to counsel patients and families appropriately about treatment and recovery following GCS. Level of evidence: IV. Study type: Epidemiological.http://www.sciencedirect.com/science/article/pii/S2352644024000402Gluteal compartment syndromeProlonged immobilizationTraumaSubstance abuseResource utilization |
| spellingShingle | Alicia M. Williams Suman Medda Meghan K. Wally Rachel B. Seymour Alexander Hysong Amber Stanley Givenchy Manzano Joseph R. Hsu Suspected gluteal compartment syndrome: Etiology predicts clinical course, outcomes and resource utilization Trauma Case Reports Gluteal compartment syndrome Prolonged immobilization Trauma Substance abuse Resource utilization |
| title | Suspected gluteal compartment syndrome: Etiology predicts clinical course, outcomes and resource utilization |
| title_full | Suspected gluteal compartment syndrome: Etiology predicts clinical course, outcomes and resource utilization |
| title_fullStr | Suspected gluteal compartment syndrome: Etiology predicts clinical course, outcomes and resource utilization |
| title_full_unstemmed | Suspected gluteal compartment syndrome: Etiology predicts clinical course, outcomes and resource utilization |
| title_short | Suspected gluteal compartment syndrome: Etiology predicts clinical course, outcomes and resource utilization |
| title_sort | suspected gluteal compartment syndrome etiology predicts clinical course outcomes and resource utilization |
| topic | Gluteal compartment syndrome Prolonged immobilization Trauma Substance abuse Resource utilization |
| url | http://www.sciencedirect.com/science/article/pii/S2352644024000402 |
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