Acute compartment syndrome complicating a distal tibial physeal fracture in a neonate

This case report of a neonate who developed an acute compartment syndrome secondary to a minimally displaced distal tibial physeal injury represents the youngest patient to be reported with such a condition. After undergoing emergency four-compartment decompression fasciotomies, the 4-week-old child had a return of normal neuromuscular function and anatomic remodeling of the fracture. It is difficult to diagnose compartment syndrome in a neonate. The patient can neither give a history, nor follow commands to cooperate with the exam. The physician must rely primarily on the physical examination; however, the quantitative measurement of intracompartmental pressure can corroborate the diagnosis of compartment syndrome. We have found using a monometer to measure intracompartmental pressure to be helpful in conjunction with a physical exam when evaluating a neonate suspected of having a compartment syndrome.