Posted by: Heather Coetzer | 2010/06/28

Injury to thigh

There is extensive edema in the superficial and the deep ,
predominantly posterolateral intermuscular compartments of the left mid and lower thigh.A
lenticulate shaped hematoma is noted in the superficial compartment measuring at least 17 cms
in length and 1.5 cms in width. In addition there is a smaller para osseous deep compartment
hemorrhage localizing mainly in the anterior compartment and measuring at least 11 cms in
Muscles : A 5 cms x 1.4 cms intramuscular hematoma involves the anterior half of the belly of the
biceps femoris in the lower third of the thigh.
NV Bundle : Major neurovascular bundle is intact.
Bones : The visible bones are normal.
Features are consistent with direct blunt injury to left mid - lower thigh with associated superficial
and deep inter and intra muscular hematoma and contusional edema - hemorrhage as described.
The hematoma involving the biceps femoris involves approx, 50 percent of the muscle thickness
at the site of maximal involvement.

This is a radiologist report regarding pertaining to an injury to his thigh after a boating accident (10 days ago) . Is it correct that this injury should not be operated on. This happened overseas and he has been advised to rest the leg for 6 weeks - would he be able to travel home bearing in mind internal bleeding and possible embolisms that might develop from the flight. Would obviously like him to recuperiate at home.
Thank you

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Our expert says:
Expert ImageOrthopaedic Specialist Forum

By this time further bleeding into the area is unlikely. i agree that surgery is not indicated. Travelling by plane is not entirely contra-indicated anymore as long as one considers the following:
- if he could travel business class and have his leg elevated sitting in the reclined position for most of the trip and only have it down for take-off and landing
-Clexane injection can be self-administered by the patient once daily during the trip which would prevent a thrombosis

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