Extract
External compression of a limb caused by casting, the use of military
antishock trousers, or prolonged positioning secondary to drug overdose or
during surgery may cause compartment syndrome in an otherwise healthy
limb1. Well-leg
compartment syndrome secondary to surgical positioning has been overwhelmingly
associated with the lithotomy or hemilithotomy
position2. A search
of the literature revealed that there have been at least twenty-six cases of
well-leg compartment syndrome associated with these positions, all of which
occurred after at least two hours of operative time and most of which occurred
after four and one-half
hours2-8.
In contrast to the lithotomy position, the lateral decubitus position has been
reported to be associated with myonecrosis and sciatic nerve palsy but not
compartment
syndrome9-11.
The leg represents one of the most common locations for acute compartment
syndrome, whereas the thigh is a relatively rare
location12. We
report two cases of compartment syndrome that were associated with prolonged
intraoperative lateral decubitus positioning, one of which involved the leg
and one of which involved the thigh. To the best of our knowledge, these are
the first two such cases that have been reported in the literature. Our
patients were informed that data concerning these cases would be submitted for
publication.