A swollen hand with blisters: a case of compartment syndrome in a child

Area of Science:

• Emergency Medicine
• Pediatric Orthopedics
• Surgical Critical Care

Background:

• Accurate identification of compartment syndrome is crucial for timely treatment and preventing long-term sequelae.
• Diagnosis can be particularly challenging in pediatric patients due to communication barriers and atypical presentations.
• Classic signs like pain, pallor, paresthesia, paralysis, and pulselessness are not always present.

Observation:

• This report details a case of compartment syndrome affecting the left hand in a child.
• The condition was caused by compression from an ACE wrap.
• The case underscores the diagnostic challenges in pediatric compartment syndrome.

Findings:

• Compartment syndrome in children may present atypically, deviating from classic signs.
• External compression, such as from an ACE wrap, can precipitate compartment syndrome in pediatric extremities.
• A high index of suspicion is necessary for early diagnosis.

Implications:

• Early recognition and intervention are vital to prevent irreversible tissue damage and functional loss.
• Clinicians should consider compartment syndrome even with subtle or absent classic signs in pediatric patients.
• Reviewing existing literature aids in understanding and managing pediatric compartment syndrome cases.