Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-23T12:59:03.440Z Has data issue: false hasContentIssue false

Acute compartment syndrome of the dorsal forearm following noncontact injury

Published online by Cambridge University Press:  21 May 2015

Brent Crawford*
Affiliation:
Department of Emergency Medicine, Grey Nuns Community Hospital, Edmonton, Alta.
Sean Comstock
Affiliation:
Department of Orthopaedic Surgery, Moncton Hospital, Moncton, NB
*
18 Hamilton Cres., St. Albert AB T8N 6R6; [email protected]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Acute compartment syndrome is a limb-threatening condition in which early diagnosis and surgical consultation for fasciotomy are required to preserve functional outcome. The diagnosis is typically considered in patients with traumatic mechanisms of injury such as a direct blow and crush to the compartment, particularly when there is a fracture in the same compartment. We report the case of a patient with acute compartment syndrome of the dorsal forearm that occurred as a result of an atypical noncontact traumatic mechanism. Establishing the diagnosis of compartment syndrome was complicated in this patient, as some of the signs and symptoms of acute compartment syndrome could have been attributed to the presence of a coexisting rupture of the extensor digitorum muscle. This report serves to remind emergency physicians that, although rare, acute compartment syndrome can result from exertional and noncontact traumatic mechanisms.

Type
Case Report • Rapport de cas
Copyright
Copyright © Canadian Association of Emergency Physicians 2010

References

REFERENCES

1.Ashton, H.Effect of inflatable plastic splints on blood flow. BMJ 1966;2:1427–30.Google Scholar
2.Shrier, I, Magder, S. Critical closing pressure and arterial resistance in an in vitro model of compartment syndrome. Med Sci Sports Exerc 1994;26(Suppl):S162.Google Scholar
3.Shrier, I, Magder, S. Pressure-flow relationships in in vitro model of compartment syndrome. J Appl Physiol 1995;79:214–21.CrossRefGoogle ScholarPubMed
4.Vaillancourt, C, Shrier, I, Vandal, A, et al. Acute compartment syndrome: How long before muscle necrosis occurs? CJEM 2004;6:147–54.CrossRefGoogle ScholarPubMed
5.Elliott, KG, Johnstone, AJ. Diagnosing acute compartment syndrome. J Bone Joint Surg Br 2003;85-B:625–32.CrossRefGoogle ScholarPubMed
6.Geogiadis, GM. Tibial shaft fractures complicated by compartment syndrome: treatment by immediate fasciotomy and locked unreamed nailing. J Trauma 1995;38:448–52.CrossRefGoogle Scholar
7.McQueen, MM, Christie, J, Court-Brown, CM. Acute compartment syndrome in tibial diaphyseal fractures. J Bone Joint Surg Br 1996;78:95–8.CrossRefGoogle ScholarPubMed
8.Blandy, JP, Fuller, R. Ischemic myositis of the leg muscles from exercise. J Bone Joint Surg Br 1957;39:679–93.Google Scholar
9.Kirby, NG. Exercise ischaemia in the fascial compartment of soleus. J Bone Joint Surg Br 1970;52:738–40.Google Scholar
10.McKee, MD, Jupiter, JB. Acute exercise-induced bilateral anterolateral leg comartment syndrome in a healthy young man. Am J Orthop 1995;24:862–4.Google Scholar
11.McHale, KM, Prahinski, JR. Acute exertional compartment syndrome occurring after performance of the army physical test. Orthop Rev 1994;23:749–53.Google Scholar
12.McQueen, MM, Gaston, P, Court-Brown, CM. Acute compartment syndrome: Who is at risk? J Bone Joint Surg Br 2000;82-B:200–3.Google ScholarPubMed
13.Mohanna, P-N, Haddad, FS. Acute compartment syndrome following noncontact football injury. Br J Sports Med 1997;31:254–5.Google Scholar
14.Allen, MJ, Barnes, MR. Unusual cause of acute superficial posterior compartment syndrome. Injury 1992;23:202–3.CrossRefGoogle ScholarPubMed
15.Moyer, RA, Boden, BP, Marchetto, PA, et al. Acute compartment syndrome of the lower extremity secondary to noncontact injury. Foot Ankle 1993;14:534–7.CrossRefGoogle ScholarPubMed
16.Williams, P, Shenolikar, A, Roberts, RC, et al. Acute non-traumatic compartment syndrome related to soft tissue injury. Injury 1996;27:507–8.CrossRefGoogle ScholarPubMed
17.Dhawan, V, Borschel, G, Brown, D. Acute exertional compartment syndrome of the forearm. J Trauma 2008;64:1635–7.Google Scholar
18.Imbriglia, JE, Boland, DM. An exercise-induced compartment syndrome of the dorsal forearm: a case report. J Hand Surg [Am] 1984;9A:142–3.Google Scholar
19.Tompkins, DG. Exercise myopathy of the extensor ulnaris muscle: report of a case. J Bone Joint Surg Am 1977;59:407–8.Google Scholar
20.Ulmer, T. The clinical diagnosis of compartment syndrome of the lower leg: Are clinical findings predictive of the disorder? J Orthop Trauma 2002;16:572–7.CrossRefGoogle ScholarPubMed
21.Bradley, EL. The anterior tibial-compartment syndrome. Surg Gynecol Obstet 1973;136:289–97.Google ScholarPubMed
22.Shadgan, B, Menon, M, O’Brien, P, et al. Diagnostic techniques in acute compartment syndrome of the leg. J Orthop Trauma 2008;22:581–7.Google Scholar
23.Tiwari, A, Haq, AI, Myint, F, et al. Acute compartment syndromes. Br J Surg 2002;89:379412.Google Scholar
24.Ho, K, Abu-Laban, RB. Ankle and foot. In: Marx, JA, Hock-berger, RS, Walls, RM, et al., editors. Rosen’s emergency medicine: concepts and clinical practice. 5th ed. St. Louis (MO): Mosby; 2002. p. 706–37.Google Scholar
25.Mars, M, Hadley, GP. Raised compartment pressure in children: a basis for management. Injury 1998;29:183–5.Google Scholar
26.White, TO, Howell, GE, Will, EM, et al. Elevated intramuscular compartment pressures do not influence outcome after tibial fracture. J Trauma Inj Infec Crit Care 2003;55:1133–8.Google Scholar
27.Mullett, H, Al-Abed, K, Prasad, CV, et al. Outcome of compartment syndrome following intramedullary nailing of tibial diaphyseal fractures. Injury 2001;32:411–3.CrossRefGoogle ScholarPubMed