The condition of increased pressure within the muscle
compartment is called compartment syndrome. Acute compartment syndrome of the
thigh is rare. In this case, fracture of the femur causes increased pressure of
the thigh that requires fasciotomy. High suspicion for thigh compartment
syndrome is recommended even in cases of minor trauma when anticoagulation
therapy or hemophilia is involved. The anterior compartment of the thigh is the
most commonly involved compartment. Fasciotomy is often necessary when the
pressure within the muscle compartment is increased. Increase pressure is
defined as an increase of absolute pressure to 30 mmHg or the pressure of the
compartment is within 30 mmHg of the diastolic pressure. If the surgeon
suspects compartment syndrome during surgery, the preoperative diastolic
pressure and not the intraoperative diastolic pressure, is used as a guide.
Once the compartmental pressure becomes elevated as mentioned before,
fasciotomy becomes necessary. Fasciotomy should be done urgently within a
reasonable period of time in order to avoid ischemia of the muscles.
