Management of Acute Compartment Syndrome During the Al Haouz Earthquake - Department of Reconstructive and Aesthetic Plastic Surgery, CHU Mohammed VI, Marrakech

On September 8, 2023, a devastating earthquake struck the Al Haouz region of Morocco, causing significant injuries, including cases of acute compartment syndrome (ACS), a surgical emergency. This report presents a case of a patient from the earthquake, treated for ACS at Mohammed VI University Hospital in Marrakech. The patient, who suffered limb trauma from debris crushing, presented with rhabdomyolysis and signs of ACS in the left upper and lower limbs. Clinical findings included functional impairment, "Coca-Cola" urine, and high creatine kinase levels (60,000), accompanied by renal failure. Decompression surgery (aponevrotomies) was performed to relieve intracompartmental pressure, followed by a directed healing protocol using the "shoe-lace" technique for wound closure. Post-operative management included antibiotics, hemodialysis for acute renal failure, nutritional support, and motor rehabilitation. Complications, such as surgical site infection and hematoma, were addressed with revision surgery and adjusted antibiotic therapy. Despite these challenges, the patient showed significant clinical improvement and resumed normal activity within three months post-operatively. This case highlights the critical importance of timely surgical intervention in ACS, particularly in disaster settings. Early diagnosis, prompt fasciotomy, effective wound management, and multidisciplinary care are essential to prevent severe complications, such as septic wounds or amputation, and ensure successful recovery.