Bilateral post-traumatic forearm and hand compartment syndrome: a case report and review of literature

Saubhik Das, Vivek Trikha, Sahil Gaba, Arkesh M., Prabhat Agrawal, Gajanand Yadav


Acute compartment syndrome is a condition in which interstitial tissue pressure within a closed osteo-fascial compartment is elevated to a nonphysiologic level causing decrease in tissue perfusion, which if left elevated for sufficient time, can lead to tissue necrosis and devastating loss of function. It poses a diagnostic and therapeutic challenge for treating surgeons. We present a case of acute post-traumatic bilateral forearm and hand compartment syndrome in a 12 year old boy associated with fracture of distal ulna and metacarpals. Patient regained excellent function with emergent fasciotomy of volar forearm and hand followed by wound management with vacuum-assisted wound closure system (VAC), delayed primary closure and split-thickness skin graft (SSG). Early diagnosis and emergent fasciotomy are crucial to avoid debilitating complications.


Bilateral, Compartment syndrome, Fasciotomy, Forearm, Hand, Split-thickness skin graft

Full Text:



Prasarn ML, Ouellette EA. Acute compartment syndrome of the upper extremity. J Am Acad Orthop Surg. 2011;19:49-58.

Volkmann R. Die ischaemischen muskellahmungen und kontrakturen. Centralbl Chir. 1881;8:801-3.

Ouellette EA, Kelly R. Compartment syndromes of the hand. J Bone Joint Surg Am. 1996;78(10):1515-22.

Ouellette EA. Compartment syndromes in obtunded patients. Hand Clin. 1998;14(3):431-50.

Prasarn ML, Ouellette EA, Livingstone A, Giuffrida AY. Acute pediatric upper extremity compartment syndrome in the absence of fracture. J Pediatr Orthop. 2009;29(3):263-8.

Whitesides TE, Heckman MM. Acute compartment syndrome: Update on diagnosis and treatment. J Am Acad Orthop Surg. 1996;4(4):209-18.

Dente CJ, Feliciano DV, Rozycki GS, Cava RA, Ingram WL, Salomone JP, et al. A review of upper extremity fasciotomies in a level I trauma centre. Am Surg. 2004;70:1088-93.

Zannis J, Angobaldo J, Marks M, DeFranzo A, David L, Molnar J, et al. Comparison of fasciotomy wound closures using traditional dressing changes and the vacuum-assisted closure device. Annals of Plastic Surgery. 2009;62(4):407-9.

Brostom LA, Stark A, Svartengren G. Acute compartment syndrome in forearm fractures. Acta Orthop Scand. 1990;61:50-3.

Söderberg TA. Bilateral chronic compartment syndrome in the forearm and the hand. J Bone Joint Surg Br. 1996;78(5):780-2.

Thomas WO, Harris CN, D'Amore TF, Parry SW. Bilateral forearm and hand compartment syndrome following thrombolysis for acute myocardial infarction: a case report. J Emerg Med. 1994;12(4):467-72.