Compartment Syndrome: The Daily PANCE Blueprint

Home Compartment Syndrome: The Daily PANCE Blueprint

Compartment Syndrome: The Daily PANCE Blueprint

A 24-year-old male is brought to the ER after a motorcycle accident. He has a closed tibial fracture and complains of severe pain in his left leg that is out of proportion to the injury. On exam, the leg is tense and swollen. Passive stretching of the toes worsens the pain. He also reports numbness. Which of the following is the most appropriate next step in management?

A. Elevate the leg and observe
B. Emergent fasciotomy
C. Administer IV morphine
D. Start broad-spectrum IV antibiotics
E. Obtain an ultrasound of the leg

Answer and topic summary

The answer is B. Emergent fasciotomy

The patient has acute compartment syndrome, which is when the tissue pressure within a closed muscle compartment exceeds the perfusion pressure. It can result in ischemia. The most common location is the calf. Many cases of acute compartment syndromes in the lower extremity are associated with fractures, burn injuries, crush injuries, or soft tissue infections. The “6 P’s” can help you remember the symptoms: pain, pallor, paresthesia, pulselessness, paralysis, and poikilothermia. Extremity fasciotomy is the treatment for acute compartment syndrome.

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Covered under ⇒ PANCE Blueprint Musculoskeletal  ⇒ Compartment Syndrome

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