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Acute compartment syndrome — RCPSC EM MCQ

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HardMusculoskeletalAcute compartment syndromeRCPSC EM

A 25-year-old man is hit in the leg with a baseball. Six hours later he has escalating pain despite opioids, tense anterior compartment and pain with passive toe extension. Dorsalis pedis pulse is present and radiograph shows no fracture. What is the most appropriate investigation?

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Correct answer: D — Measure compartment pressures if diagnosis is uncertain and consult orthopaedics for emergent fasciotomy

Acute compartment syndrome is a clinical diagnosis; intact pulses do not exclude it. Severe pain, tense compartment and pain with passive stretch require urgent fasciotomy consultation.

Reference: Canadian orthopaedic trauma principles; Rosen's Emergency Medicine