Concomitant Venous Thrombosis and Pulmonary Embolism After Hip Arthroscopy in a Patient With Heterozygous Factor V Leiden Deficiency.

As hip arthroscopy becomes more prevalent, it is imperative to identify potential risks associated with this procedure. In this article, we report a case of deep vein thrombosis (DVT) and pulmonary embolism that developed after hip arthroscopy in a moderate-risk patient with heterozygous factor V Leiden deficiency. The patient concomitantly developed DVT and pulmonary embolism during a 5-day course of treatment with subcutaneous enoxaparin. The American College of Chest Physicians and American Academy of Orthopaedic Surgeons guidelines on postarthroplasty DVT prophylaxis do not address thromboprophylaxis in hip arthroscopy. Guidelines on managing venous thromboembolism after hip arthroscopy are needed. With complications increasing, protocols should be implemented to address the potential risks of this popular procedure.

Distal biceps brachii tendon rupture resulting in acute compartment syndrome.

Distal biceps brachii tendon rupture is an uncommon injury. Compartment syndrome of the upper arm is rarely described in the literature. The diagnosis of upper arm compartment syndrome requires a high index of suspicion, and emergent surgical treatment with fasciotomy in the acute setting is necessary to avoid devastating neurovascular complications. This article reports a case of acute compartment syndrome of the anterior compartment of the upper arm after a complete rupture of the distal biceps brachii tendon. A healthy 45-year-old man presented with increasing arm pain; paresthesia in the lateral antebrachial cutaneous nerve distribution; and a tense, swollen anterior compartment of his upper arm. Side port catheter absolute pressure measurement was 83 mm Hg with a diastolic blood pressure of 92 mm Hg. The patient underwent an emergent fasciotomy and was found to have a complete rupture of his distal biceps brachii tendon. He subsequently underwent distal biceps tendon repair and delayed primary closure of his incision. Postoperatively, his paresthesia improved and he has no neurological deficit. There is a paucity of case reports describing compartment syndrome after rupture of either the proximal or distal end of the biceps brachii tendon, and none of the reports describe compartment syndrome of the upper arm after rupture of the distal biceps tendon. This article highlights an unusual complication of an uncommon injury and reviews diagnostic and treatment principles for the management of acute compartment syndrome of the upper arm.