Peroneal nerve palsy and compartment syndrome in bilateral femoral fractures.

Four patients with bilateral femoral shaft fractures sustained 4 peroneal nerve palsies and 2 compartment syndromes during supine intramedullary nailings of their fractures. In each case, the compartment syndrome or common peroneal nerve palsy or both developed in the leg that was placed initially in the calf-supported leg holder during intramedullary rodding of the contralateral femur. Three of 4 patients had near to full recovery of motor strength postoperatively. The authors recommend that a leg with a fractured femur not be positioned in a calf-supported leg holder.