Acute compartment syndrome of the thigh is a rare clinical entity often caused by high-energy trauma and presenting with a spectrum of associated injuries. Service members in combat are at risk for these causative mechanisms. This study presents a large cohort of thigh compartment syndrome combat casualties and investigates the injury mechanisms, associated mortality, and complications related to fasciotomies. Blasts were the most frequent injury mechanism, overall mortality was 23%, burns were associated with a higher mortality, and fasciotomy morbidity was reported by all respondents. The mortality was similar to civilian cohorts with thigh compartment syndrome and was isolated to patients with high Injury Severity Scores. While mortality associated with this injury is high, it is likely related to associated injury patterns rather than the compartment syndrome itself. Thigh compartment fasciotomies carried significant morbidity, consistent with civilian trauma publications.
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