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Juke Stick: A Case of Pediatric Atraumatic Compartment Syndrome
Brandon Oswald1, Devin R DeFeo2, Joseph W Jude1
1Emergency Medicine Residency, Carl R. Darnall Army Medical Center, Fort Cavazos, TX 76544, USA.
Military Medicine
|August 31, 2023
Summary
Atraumatic compartment syndrome can occur in athletes, presenting with leg pain and swelling. Early diagnosis using pressure measurement and fasciotomy can prevent long-term disability.
Area of Science:
- Orthopedics
- Sports Medicine
- Emergency Medicine
Background:
- Compartment syndrome, typically trauma-induced, compromises neurovascular and muscle function.
- It classically presents with the six P's: pain, pallor, paresthesia, paralysis, poikilothermia, and pulselessness.
- Diagnosis is confirmed by a delta pressure <30 mmHg.
Observation:
- A 15-year-old football player presented with atraumatic compartment syndrome in his right lower leg.
- Symptoms of pain and swelling emerged after a sports maneuver, initially improving with rest but worsening upon return to play.
- Physical examination revealed tenderness, decreased strength and sensation, and edema, with bedside ultrasound noting swelling.
Findings:
- Compartment pressure measurement revealed a delta pressure of 26 mmHg, confirming the diagnosis.
- The patient underwent fasciotomy, a surgical procedure to relieve pressure.
- He recovered fully to his baseline function without any lasting deficits.
Implications:
- Recognizing atraumatic compartment syndrome is crucial for timely diagnosis and preventing disability in athletes.
- Disposable pressure transducers offer a cost-effective and accurate method for diagnosing compartment syndrome in emergency settings.
- This case highlights the importance of considering less common causes of compartment syndrome in active individuals.
