Non-fracture acute compartment syndrome in the upper extremity of a 14-year-old boy: A case report and review of the literature

TY - JOUR

T1 - Non-fracture acute compartment syndrome in the upper extremity of a 14-year-old boy: A case report and review of the literature

AU - Niklaus, Marina

AU - Reinshagen, Konrad

AU - Wintges, Kristofer

N1 - Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

PY - 2024/8

Y1 - 2024/8

N2 - INTRODUCTION: Acute compartment syndrome (ACS) is an orthopaedic emergency affecting all age groups, yet diagnosis proves particularly difficult within the paediatric population and especially in the absence of fractures.CASE PRESENTATION: In this case report, we detail a rare instance of a non-fracture acute compartment syndrome (NFACS) in a 14-year-old boy, initially missed due to lack of suspicion. Symptoms included swelling, severe pain, and initial paresthesia in the hand. Despite prompt forearm fasciotomy, severe post-traumatic Volkmann contracture ensued, resulting in limited upper extremity function despite multiple corrective surgeries.CLINICAL DISCUSSION: Acute compart syndromes, occurring without fractures, often faces delayed diagnosis, particularly in paediatrics population. Clinical examination remains the diagnostic gold standard, with analgesia refractory pain warranting suspicion. Additional diagnostic criteria like ultrasound, MRI or CK blood values can be evaluated with reservation, especially in the paediatric population.CONCLUSION: This case highlights the importance of increased vigilance in diagnostics for NFACS especially in children, in order to not overlook NFACS, due to the wide variability in the aetiology and clinical appearance. We emphasize the relevance of clinical diagnostics and point out an increased awareness of NFACS in analgesic refractory pain.

AB - INTRODUCTION: Acute compartment syndrome (ACS) is an orthopaedic emergency affecting all age groups, yet diagnosis proves particularly difficult within the paediatric population and especially in the absence of fractures.CASE PRESENTATION: In this case report, we detail a rare instance of a non-fracture acute compartment syndrome (NFACS) in a 14-year-old boy, initially missed due to lack of suspicion. Symptoms included swelling, severe pain, and initial paresthesia in the hand. Despite prompt forearm fasciotomy, severe post-traumatic Volkmann contracture ensued, resulting in limited upper extremity function despite multiple corrective surgeries.CLINICAL DISCUSSION: Acute compart syndromes, occurring without fractures, often faces delayed diagnosis, particularly in paediatrics population. Clinical examination remains the diagnostic gold standard, with analgesia refractory pain warranting suspicion. Additional diagnostic criteria like ultrasound, MRI or CK blood values can be evaluated with reservation, especially in the paediatric population.CONCLUSION: This case highlights the importance of increased vigilance in diagnostics for NFACS especially in children, in order to not overlook NFACS, due to the wide variability in the aetiology and clinical appearance. We emphasize the relevance of clinical diagnostics and point out an increased awareness of NFACS in analgesic refractory pain.

U2 - 10.1016/j.ijscr.2024.109983

DO - 10.1016/j.ijscr.2024.109983

M3 - Case report

C2 - 38964235

VL - 121

SP - 109983

JO - INT J SURG CASE REP

JF - INT J SURG CASE REP

SN - 2210-2612

ER -