Acute Forearm Compartment Syndrome in a Toddler Caused by Hematoma without Fracture: A Case Report

Acute forearm compartment syndrome (AFCS) is rare in pediatric patients. Diagnosis of AFCS in pediatric patients is often difficult based on their presentation variability and immature verbal. We present a case of AFCS in a toddler who showed specific congestion from the distal forearm to the hand that resulted in a hematoma without fracture.

A 2-year-old boy had right upper extremity pain and paralysis after falling from a chair. He had no family history of congenital hemorrhagic diseases or anticoagulant medications. His right distal forearm to hand was congested with a clear borderline to the proximal forearm. It was unable to detect any fractures in the X-rays. We diagnosed him with AFCS and performed a fasciotomy that showed a developing hematoma around the carpal tunnel. Two years after surgery, he had no signs of neurological defect in the upper extremity.

The toddler was injured by a low-energy fall, which was atypical enough to suggest the onset of ACFS. Congestion beyond the wrist, with a clear border to the proximal area, indicating peripheral circulatory disturbance, was the most notable physical finding in this case.