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Gluteal Compartment Syndrome

MacLean, Jeffrey MD; Wustrack, Rosanna MD; Kandemir, Utku MD

Techniques in Orthopaedics:
doi: 10.1097/BTO.0b013e318249a997

The gluteal region contains 3 distinct myofascial compartments at risk for development of compartment syndrome. Although rare, the most commonly cited etiology is prolonged immobilization or as a complication of intraoperative positioning. Classic symptoms including localized swelling and pain with passive stretch are common presenting symptoms and distal neurological deficits can be seen in approximately half of the patients. Best practice guidelines are based exclusively on a handful of case series and case reports available. Diagnosis relies on the clinical exam and intracompartmental pressure measurements, and may be aided by angiography or other imaging studies. The mainstay of treatment is surgical decompression and delayed primary closure. Immediate complications include infection, acute renal failure, and death; however, as many as 50% of patients treated with surgical decompression may recover with no functional or neurological deficits. We review the history, etiology, diagnosis, and surgical technique used in the treatment of gluteal compartment syndrome.

Author Information

Department of Orthopaedic Surgery, University of California, Orthopaedic Trauma Institute, San Francisco, CA

The authors declare that they have nothing to disclose.

Address correspondence and reprint requests to Utku Kandemir, MD, Department of Orthopaedic Surgery, University of California, Orthopaedic Trauma Institute, 2550 23rd St, Building 9, 2nd Floor, San Francisco, CA 94110. E-mail:

Received January 3, 2012

Accepted January 4, 2012

© 2012 Lippincott Williams & Wilkins, Inc.