Neonatal Compartment Syndrome Treated Within the First 24 Hours of Life

Neonatal compartment syndrome is rare. There are multiple proposed etiologies, including infection, vascular insult, and mechanical compression. Much like compartment syndrome in adults, delayed surgical intervention for neonatal compartment syndrome can have catastrophic results. The authors present a unique case of a neonate who presented with left forearm and hand swelling and skin ulceration after vaginal delivery. Findings from the evaluation for vascular injury, infection, and hypercoagulability were normal. The neonate was diagnosed with compartment syndrome and underwent decompressive fasciotomy of the forearm flexor and extensor compartments as well as hand intrinsic and thenar compartments within the first 24 hours of life. At 5 years old, the patient had progressive radial clubbing and a 41-mm limb length discrepancy due to growth arrest at the distal radial physis. A radial distraction osteogenesis was then performed. Postoperatively, the patient continues to improve her range of motion and strength through rehabilitation. [Orthopedics. 2018; 41(5):e731-e733.].