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Compartment syndrome — ABEM Board MCQ

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ModerateTraumaCompartment syndromeABEM Board

A 22-year-old man arrives 6 hours after a tibial fracture was splinted. Triage acuity is ESI 2; BP 132/80 mm Hg, HR 112/min. He has escalating leg pain despite opioids and pain with passive toe extension. The compartments are tense, and pulses remain palpable. Which of the following is the most likely diagnosis?

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Correct answer: D — Acute compartment syndrome

Pain out of proportion and pain with passive stretch after fracture indicate compartment syndrome; pulses may persist until late.

Reference: ATLS extremity trauma guidance