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Acute Tubular Necrosis from Rhabdomyolysis from Leg Compartment Syndrome

A Case Report

DeWolf, Matthew C. MD1; Norman, Mackenzie B. BS2; Molloy, Ilda B. MD1; Yong, Taylor M. MD1; Ramkumar, Dipak B. MD, MS1; Veerareddy, Rakesh R. MBBS1

doi: 10.2106/JBJS.CC.18.00318
Case Reports

Case: A 31-year-old male sustained acute compartment syndrome to his left leg after a low-energy fall and required a 4-compartment fasciotomy release. His immediate postoperative course was complicated by acute tubular necrosis (ATN) with creatinine elevated to 4.89 mg/dL from rhabdomyolysis. ATN was managed with aggressive hydration, sodium bicarbonate, and alkaline diuresis, and his creatinine levels improved.

Conclusions: ATN from rhabdomyolysis is a rare complication of compartment syndrome that requires high suspicion and timely treatment to prevent further nephrotoxicity and the resultant increases in mortality. It is imperative for orthopedic surgeons to be aware of this potential complication.

1Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire

2Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire

E-mail address for M.C. DeWolf:

Investigation Performed at Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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