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Compartment syndrome — MCCQE Part 1 MCQ

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EasyFracturesCompartment syndromeMCCQE Part 1

A 22-year-old man with a tibial fracture has escalating pain despite opioids and pain on passive toe extension; foot pulses are present. Which of the following is the most appropriate next step?

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Correct answer: A — Urgent surgical fasciotomy assessment for compartment syndrome

Urgent surgical fasciotomy assessment for compartment syndrome is the single best answer because the age, timing, examination findings and investigations in the vignette fit Compartment syndrome better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Orthopaedic Association guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Orthopaedic Association guidance