Kompartment-Syndrom am Femur nach Kontusionstrauma beim Team-Handball

In September 2012, a 35-year-old semi-professional team handball player (right wing, 3rd national team handball league) injured his left lateral femur during a game in an offense action, when his opposing player hit him directly with his knee. After on-site inspection and local ice application, the athlete was transferred into a hospital, where a clinical and an ultrasound examination were performed; a hematoma was diagnosed and the patient was released. Two days later, the athlete was urgently admitted to a hospital after clinical examination by a general practitioner to undergo surgery with facial release and dissection as well removal of a hematoma caused by an increasing compartment syndrome. Owing to a progressive situation and ongoing bleeding, the patient was treated in a total of nine surgical revisions including skin transplantation for defect reconstruction and endovascular intervention with vascular clipping (coiling). The surgical procedures were completed without any further complication apart from a muscular herniation at the left lateral femur (Vastus lateralis muscle), which was technically treated with compression trousers. The athlete did recover completely but was unable to take up team handball sports again.ConclusionsIn contact sports such as team handball, athletes should be examined and checked in short periods after direct soft tissue contusion; sport activity should preferably be discontinued. Ultrasound examinations should be performed as soon and often as possible to exclude and follow any structural damages and hematoma. This allows compartment syndromes to be determined and diagnosed at an earlier stage and, if necessary, to be surgically treated with a high degree of success.