Ward round--Late presentation of acute compartment syndrome in the thigh.

Acute compartment syndrome of the thigh is rare but has been described as a result of femur fracture and also thigh contusion in sports injury. Emergency fasciotomy has routinely been the recommended treatment. We describe a patient with a closed femur fracture, initially without any syndrome whilst on traction, and required surgical intervention. He was found to have a large haematoma associated with significant muscle damage in the posterior compartment. This case is unusual in that symptoms started 12 days after injury possibly after manipulation of the leg whilst on traction. Diagnosis is mainly clinical with an earliest alarming sign being disproportional increasing pain on passive stretch of the group of muscles. A high index of suspicion and prompt intervention are required to diagnose and treat compartment syndrome and prevent irreversible damage.