Unusual presentation of acute compartment syndrome of the forearm and hand

Abstract

A 49-year-old man was referred to orthopaedics with an acute onset of left forearm and hand swelling, widespread blisters and erythema after lying face down on the floor for an unknown period of time. He also presented with left wrist stiffness due to pain and clawing of the fingers and glove-type loss of sensation in the whole hand. Any attempt to straighten the fingers or extend the wrist exacerbated the pain. Symptoms deteriorated rapidly. Compartment syndrome was diagnosed and surgical fasciotomies of his left forearm and left hand were performed following multidisciplinary urgent discussions between plastic surgeons, microbiologists, anaesthetists and orthopaedic surgeons. The left forearm and left hand underwent extensive decompression and subsequent skin grafting and had good healing despite the initial skin presentation. The patient has made a satisfactory recovery and has required extensive hand physiotherapy and social care.

Atypical compartment syndrome of the forearm due to mixed infection with Proteus mirabilis and Morganella morganii after a penetrating injury: A limb-saving approach

“…[ 13 ] Current literature suggests that surgical fasciotomy of the involved compartments remains the gold-standard treatment approach, irrespective of the cause, condition, or location. [ 14 ] Stull et al[ 7 ] performed dualincision fasciotomy instead of a standard singleincision to avoid contamination of the uninvolved compartments in a patient with ACS secondary to a Proteus-infected hematoma. However, we decided to use a standard single-incision approach for our patient.…”

“…The literature review shows that unusual anatomical locations, rare conditions, drug interactions, and their side effects as well as surgical procedures and rare fractures can be associated with ACS. [ 7 , 13 , 14 ] There is limited knowledge about an infected hematoma associated with ACS,[ 7 ] and the authors of this case report describe a coinfection of forearm hematoma leading to ACS for the first time in the literature. [ 15 ] Proteus mirabilis and M. morganii were isolated as coinfectious agents in this case.…”

Nursing outcomes of traditional Chinese medicine adjunctive therapy on osteofascial compartment syndrome: a review†

“…Pain out of proportion and pain with passive stretching of the fingers are usually considered the first and the most sensitive signs of OCS in a noncomatose patient, in contrast to pulselessness, which has been reported as a late or even end-stage sign. 13,14 Whether regional anesthesia can delay the diagnosis of OCS is still debated. 3 The diagnosis and treatment of OCS should be standardized even though there is no unified consensus currently.…”

Complex approach to the treatment of phegmon and compartment syndrome of the upper limb

“…Однако в большинстве случаев хирурги не проводят диагностику компартмент-синдрома при гнойных заболеваниях мягких тканей [4]. Часто при клинических проявлениях синдрома (боли давящего и пекущего характера, онемении некоторых или всех сегментов конечности) их пытаются купировать путем назначения нестероидных противовоспалительных средств [5].…”