From the Research
Complications of Hematoma in the Leg
- Necrosis of the overlying skin due to increased tissue pressure 1
- Tissue ischemia and necrosis due to multiple cellular and biochemical changes 1
- Skin necrosis requiring debridement and reconstruction with a split skin graft 2
- Abscess formation, although rare, with only 4 cases reported out of 1,000 operated legs 3
- Femoral nerve palsy caused by iliacus hematoma, which can lead to devastating outcomes if not promptly recognized and managed 4
- Bleeding complications, particularly in patients on anticoagulation therapy, which can increase the risk of hematoma formation 5
Risk Factors for Complications
- Trauma, which is the single most important predisposing cause of iliacus hematoma 4
- Antiplatelet medications, which can increase the risk of spontaneous hematoma 4
- Anatomical factors, such as varicose veins topography and perforating veins, which can contribute to hematoma formation 3
- Patient factors, such as obesity, which can make hematoma more spectacular 3
Treatment and Management
- Prompt recognition and operative evacuation of hematomas to avoid significant complications 1
- Conservative treatment with analgesia, which can be considered initially in patients with iliacus hematoma and no progressive neurological deficits 4
- Surgical decompression, which is highly recommended in patients with progressive neurological deficits 4
- Peripheral regional anesthesia, which can be considered despite an elevated bleeding risk, after careful risk-benefit analysis 5