Bilateral Compartment Syndrome in Intravenous Drug Abuse

Compartment syndrome is an orthopedic emergency in which the neurovasculature of the extremity is compromised. Typically, it presents unilaterally and is the consequence of major trauma to the extremity in the form of fracture. However, more uncommon etiologies of compartment syndrome have been reported, which includes reperfusion injury, burns, and congenital or acquired bleeding disorders. We present an extremely rare case of bilateral posterior thigh compartment syndrome thought to be due to intravenous drug abuse (IVDA) causing prolonged ischemia with subsequent reperfusion. This case is particularly relevant in today’s clinical setting given the current opioid epidemic and subsequent rise in intravenous drug use.