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Spontaneous iliacus haematoma with femoral nerve palsy: an appeal to involve surgical teams early
  1. Alexander M Crawford1,
  2. Theodore T Guild1,
  3. Brendan M Striano1 and
  4. Arvind G Von Keudell2
  1. 1Harvard Combined Orthopaedic Residency Program, Boston, Massachusetts, USA
  2. 2Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Alexander M Crawford; acrawford7{at}partners.org

Abstract

We report the case of a 68-year-old man who was placed on heparin as bridge therapy and subsequently developed an iliacus haematoma with associated femoral nerve palsy. His team involved the orthopaedic surgery team in delayed fashion after his symptom onset. Due to his active medical conditions, he did not undergo surgical decompression of his haematoma until late into his hospital course. Unfortunately, this patient did not regain meaningful function from his femoral nerve deficit. We believe this case highlights the high index of suspicion necessary for making this diagnosis as well as the repercussions of an untimely decompression for this acute, compressive neuropathy. Although we are surgeons and this is a surgical case, we hope to publish this case in a medical journal to raise awareness that surgical decompression does have a role in this diagnosis and should ultimately be pursued early in its course for optimal patient benefit.

  • haematology (incl blood transfusion)
  • neurological injury
  • orthopaedics
  • surgery

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Footnotes

  • Contributors AMC, TTG, BMS: conceptualised, designed and drafted the submitted work, made final approval of the submitted manuscript, and agreed to be accountable for all aspects of the work. AGVK: conceptualised, designed and revised the submitted work, made final approval of the submitted manuscript, and agreed to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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