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The Journal of Bone and Joint Surgery 80:1789-90 (1998)
© 1998 The Journal of Bone and Joint Surgery, Inc.

Delayed Onset of Anterior Tibial Compartment Syndrome in a Patient Receiving Low-Molecular-Weight Heparin. A Case Report*

JOHN A. McLAUGHLIN, M.D.{dagger}, MELYSSA M. PAULSON, M.D.{ddagger} and RONALD E. ROSENTHAL, M.D.{ddagger}, NEW HYDE PARK, NEW YORK

Investigation performed at the Department of Orthopaedic Surgery, Long Island Jewish Medical Center, New Hyde Park


   Introduction
 
Patients who have sustained a major traumatic injury of a lower extremity are at high risk for the development of deep-vein thrombosis. The use of low-molecular-weight heparin for prophylaxis against deep-vein thrombosis in such patients has been advocated by several authors2,4,5,7,9,12. Major complications attributed to the use of low-molecular-weight heparin have included hemorrhage2,8 and spinal epidural hematoma13.

Compartment syndrome usually is associated with high-energy or crush injuries. The symptoms of compartment syndrome usually present within twenty-four to forty-eight hours. Compartment syndromes occurring in the absence of an underlying osseous injury are unusual.

We describe a case of delayed-onset compartment syndrome of the leg in a patient who was receiving low-molecular-weight heparin.


   Case Report
 
A thirty-three-year-old man sustained injuries of the left lower extremity in a motor-vehicle accident. The patient was otherwise healthy and had no known hepatic, clotting, or bleeding abnormalities. Physical and radiographic examination revealed closed segmental fractures of . . . [Full Text of this Article]


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