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Published on: May 31, 2019
Recurrent metachronous acute compartment syndrome in the legs of a child
J D Ogunlusi1, R St George, B St Rose
1Victoria Hospital, Castries. St Lucia. West Indies. gbemidare@yahoo.com
Insights
Metachronous compartment syndrome is rare in children. This case highlights the importance of suspecting this condition after minor trauma and performing complete fasciotomy to prevent recurrence.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
Background:
- Compartment syndrome is uncommon in pediatric patients.
- Metachronous compartment syndrome, occurring sequentially in different limbs or different sites within the same limb, is exceptionally rare.
Observation:
- A seven-year-old boy experienced four episodes of acute compartment syndrome in his legs over three years.
- Each leg was affected twice, following minor injuries, between the ages of three and seven.
Findings:
- Initial treatment involved fasciotomy of one or two compartments per affected leg.
- Following fasciotomy of all four compartments during the second presentation of each leg, no recurrence was observed.
Implications:
- This case underscores the possibility of metachronous compartment syndrome in children after trivial trauma.
- A high index of suspicion is crucial for timely diagnosis.
- Complete fasciotomy of all four compartments is vital to prevent recurrent episodes.
Background:
Compartment syndromes in children are rare, rarer still is the occurrence of metachronous compartment syndrome.
Objective:
To report an unusual and rare presentation of metachronous acute compartment syndrome.
Methods:
A seven-year-old boy presented with four separate episodes of acute compartment syndrome of the legs within three years. The recurrent nature of the illness prompted detail review of the records of the child.
Results:
There was involvement of each leg twice between the ages of three and seven years following trivial trauma. At first presentation of each leg, fasciotomy was carried out in one or two compartments. There was no recurrence after fasciotomy of the four compartments during the second presentation of each leg.
Conclusions:
This case shows that a child could develop metachronous compartment syndrome in the legs following trivial injury and high index of suspicion is needed to recognize it. It also illustrates the importance of carrying out fasciotomy of all the four compartments to avoid recurrence of the pathology.
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