Acute compartment syndrome risk in fracture fixation with regional blocks

Acute compartment syndrome is a surgical emergency that most commonly occurs after trauma or reperfusion after prolonged arterial occlusion. It is caused by a build-up of blood and oedema fluid within a closed muscle compartment, and can be limb and life-threatening. It is therefore imperative that a prompt diagnosis is made. The risk of developing this condition is <1% in patients with distal radius fractures and 4-5% in those with tibial diaphyseal fractures. Pain management is an important aspect of treatment following any fracture. Regional anaesthesia can be used during surgical fixation of the fracture and has the potential to reduce the need for specialist postoperative care and analgesia, as well as to shorten the length of hospitalisation. With this case report, we hope to highlight the potential risk of masking symptoms of compartment syndrome while using regional blocks, as this can cause a delay in diagnosis and treatment, leading to associated complications.