Presentation
Post-road traffic accident with right femur shaft displaced fracture underwent surgical fixation, two days later the patient suffered from severe right lower limb pain, swelling, coldness and pulseless, ischemia was suggested and prompted for CT angiography
Patient Data
Diffuse swelling and edema with ill defined collections of the right thigh are seen involving its deep and superficial compartments with multiple air locules within that are most likely either secondary to operative intervention or infection. The edema and collection are seen compressing all the arteries in the right thigh causing marked compromise of the blood flow within, evident as lack of contrast filling in the lower one third superficial femoral artery, most of profunda femoris artery, whole popliteal and infra-popliteal vessels on the right side (picture of compartment syndrome is considered).
Comminuted fracture of the right mid-femoral shaft with metallic hardware fixation using intra-medullary nail.
Case Discussion
CT finding of acute compartment syndrome of the right thigh causing marked compromise of the flow in the right femoro-popliteal and infrapopliteal vessels as described.
So, urgent fasciotomy was done to relieve this compression and evacuate collections as well as hematomas.
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