title: Bilateral simultaneous traumatic upper arm compartment syndromes associated with anabolic steroids.
abstract: BACKGROUND
  Acute compartment syndrome, a surgical emergency, is defined as increased pressure in an osseofascial space. The resulting reduction of capillary perfusion to that compartment requires prompt fasciotomy. Treatment delay has a poor prognosis, and is associated with muscle and nerve ischemia, resultant infarction, and late-onset contractures.
  
  
  OBJECTIVE
  We report a case of traumatic bilateral upper limb acute compartment syndrome associated with anabolic steroids, requiring bilateral emergency fasciotomies.
  
  
  METHODS
  A 25-year-old male bodybuilder taking anabolic steroids, with no past medical history, presented to the Emergency Department 25 min after a road traffic accident. Secondary survey confirmed injuries to both upper limbs with no distal neurovascular deficit. Plain radiographs demonstrated bilateral metaphyseal fractures of the distal humeri. Within 2 h of the accident, the patient developed clinical features that were consistent with bilateral upper arm compartment syndrome. Bilateral fasciotomies of both anterior and posterior compartments were performed, confirming clinical suspicion.
  
  
  CONCLUSIONS
  We suggest consideration of a history of anabolic steroid use when evaluating patients with extremity trauma.
authors: Nuffield Orthopaedic Centre, Oxford, UK.
authors: Gurhan
authors: G
authors: Erturan
authors: Nev
authors: N
authors: Davies
authors: Huw
authors: H
authors: Williams
authors: Sunny
authors: S
authors: Deo
mesh_terms: D000063:Accidents, Traffic; D000208:Acute Disease; D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects*; D001134:Arm Injuries / Q000150:complications*; D003161:Compartment Syndromes / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging*; D008297:Male; D011859:Radiography; D013256:Steroids / Q000009:adverse effects*
chemical_list: D045930:Anabolic Agents; D013256:Steroids