[Hemilithotomy position for intramedullary nailing of the femur and compartment syndrome of the healthy leg].

Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera

PubMedID: 12227114

Christodoulou M, Garofalo R, Echeverri S, Pelet S, Mouhsine E. [Hemilithotomy position for intramedullary nailing of the femur and compartment syndrome of the healthy leg]. Swiss Surg. 2002;8(4):193-6.
The well leg compartment Syndrome following long procedures in the dorsal lithotomy or hemi-lithotomy position is a rare complication. Its diagnosis is usually late and the neurological deficit are often permanent. We report two cases of femoral nailing complicated by Compartment Syndrome of the contralateral leg. We review the published literature on 40 cases which suggests a clear relationship between these positions, the duration of the intervention and the degree of leg elevation. Given the potentially severe sequel, prevention is a must and a high degree of suspicion is the key to an early diagnosis. A modified hemi-lithotomy position is proposed. That avoids extreme elevation of the leg and diminishes the hip and knee flexion required while allowing adequate fluoroscopy.