Acute compartment syndrome of the deltoid: a case report and systematic review of the literature.

Deltoid acute compartment syndrome compartment pressure fasciotomy shoulder upper extremity

Journal

JSES international
ISSN: 2666-6383
Titre abrégé: JSES Int
Pays: United States
ID NLM: 101763461

Informations de publication

Date de publication:
Dec 2020
Historique:
entrez: 21 12 2020
pubmed: 22 12 2020
medline: 22 12 2020
Statut: epublish

Résumé

Deltoid compartment syndrome is a rare entity. The purpose of this study was to report a recent case and perform a systematic literature review. Patient data were gathered from chart review and clinical encounters. For the review, the MEDLINE, Embase, and Ovid databases were queried for deltoid compartment syndrome cases. Seventeen articles reporting on 18 patients with deltoid compartment syndrome were included. Including our patient, 9 of 19 patients (47.4%) presented with compartment syndrome limited to the deltoid. Most patients presented with additional affected compartments, most commonly in the ipsilateral arm (7 of 19, 37%). Isolated deltoid involvement often resulted from iatrogenic injury; of 10 iatrogenic reports, 8 involved only the deltoid. Of 19 cases, 5 (26%) occurred in powerlifters, climbers, or anabolic steroid or testosterone injectors. In 13 of 19 cases (68%), the patients were men aged 18-36 years, and only 1 female case (5%) was reported. Prolonged recumbence owing to substance abuse was documented in 6 of 19 cases (32%). Deltoid compartment syndrome is rare, with only 19 reported cases, including our patient. Men are more commonly affected, and isolated deltoid compartment syndrome occurs in about 50% of reported cases. More than half of cases are iatrogenic, secondary to prolonged lateral decubitus positioning, injections, and surgical interventions about the shoulder. Prolonged recumbence from intoxication is also a common etiology. Providers should be aware of and recognize deltoid compartment syndrome to facilitate urgent surgical management.

Sections du résumé

BACKGROUND BACKGROUND
Deltoid compartment syndrome is a rare entity. The purpose of this study was to report a recent case and perform a systematic literature review.
METHODS METHODS
Patient data were gathered from chart review and clinical encounters. For the review, the MEDLINE, Embase, and Ovid databases were queried for deltoid compartment syndrome cases. Seventeen articles reporting on 18 patients with deltoid compartment syndrome were included.
RESULTS RESULTS
Including our patient, 9 of 19 patients (47.4%) presented with compartment syndrome limited to the deltoid. Most patients presented with additional affected compartments, most commonly in the ipsilateral arm (7 of 19, 37%). Isolated deltoid involvement often resulted from iatrogenic injury; of 10 iatrogenic reports, 8 involved only the deltoid. Of 19 cases, 5 (26%) occurred in powerlifters, climbers, or anabolic steroid or testosterone injectors. In 13 of 19 cases (68%), the patients were men aged 18-36 years, and only 1 female case (5%) was reported. Prolonged recumbence owing to substance abuse was documented in 6 of 19 cases (32%).
CONCLUSION CONCLUSIONS
Deltoid compartment syndrome is rare, with only 19 reported cases, including our patient. Men are more commonly affected, and isolated deltoid compartment syndrome occurs in about 50% of reported cases. More than half of cases are iatrogenic, secondary to prolonged lateral decubitus positioning, injections, and surgical interventions about the shoulder. Prolonged recumbence from intoxication is also a common etiology. Providers should be aware of and recognize deltoid compartment syndrome to facilitate urgent surgical management.

Identifiants

pubmed: 33345211
doi: 10.1016/j.jseint.2020.07.016
pii: S2666-6383(20)30124-9
pmc: PMC7738586
doi:

Types de publication

Case Reports

Langues

eng

Pagination

753-758

Informations de copyright

© 2020 The Author(s).

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Auteurs

Joseph P Scollan (JP)

Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.

Morgan L Bertsch (ML)

Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.

Christopher D Flanagan (CD)

Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Morad Chughtai (M)

Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.

Kyle J Chepla (KJ)

Department of Plastic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Department of Plastic Surgery, MetroHealth Medical Center, Cleveland, OH, USA.

Harry A Hoyen (HA)

Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Department of Orthopaedic Surgery, MetroHealth Medical Center, Cleveland, OH, USA.

Blaine T Bafus (BT)

Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Department of Orthopaedic Surgery, MetroHealth Medical Center, Cleveland, OH, USA.

Classifications MeSH