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CASE REPORT Spontaneous Forearm Compartment Syndrome in a Boy With Hemophilia A: A Therapeutic Dilemma
Jennifer Kim1, Jonathan Zelken, Justin Michael Sacks
1The Johns Hopkins Hospital, Department of Plastic and Reconstructive Surgery, Baltimore, MD.
Objective:
We present the case of a 14-year-old Factor VIII-deficient patient with no history of trauma, who developed acute spontaneous compartment syndrome of the volar forearm. We also suggest a treatment strategy.
Methods:
Fasciotomy with hematoma evacuation and ipsilateral carpal tunnel release was performed, and the wound was closed with vascular loops in "Jacob's ladder" fashion. Factor infusions were continued overnight.
Results:
The volar forearm compartment was successfully decompressed, and the patient's coagulopathy was managed with appropriate clotting factors.
Conclusions:
Hemophilic patients warrant special consideration and multispecialty care; with replenished coagulation factors and timely surgical decompression, they can expect satisfactory recovery of muscular and neurological function.
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