Fasciotomy and Skin Graft in a 71-year-old Patient with Compartment Syndrome of the Volar Forearm after an Olecranon Fracture

Introduction:Compartment syndrome is a life-threatening orthopaedic emergency that occurs due to increased pressure within a closed muscle compartment, compromising circulation and leading to tissue ischemia, necrosis, amputation, or even death1. Early detection of compartment syndrome is essential to preserve motor and sensory function in the extremity. Surgeons must also remain conscious of the patient’s metabolic and kidney status to prevent AKI secondary to rhabdomyolysis from severe muscle breakdown3. In cases where there is significant ischemia and necrosis of the muscle, immediate fasciotomy and debridement are indicated3. The classic presentation of compartment syndrome includes the four P’s: pulselessness, pallor, paresthesia, and pain with passive stretch1. The incidence of acute compartment syndrome is estimated to be 7.3 per 100,000 males and 0.7 per 100,000 females1. Risk factors include age under 35 years, male gender, and high-intensity exercise4. There is additional risk in insensate and obtunded patients. Compartment syndrome is seen most often with associated fracture, most often of the tibial shaft. Acute compartment syndrome of the forearm with associated fracture was seen most commonly in men under the age of 35 as well4. We present a case of a 71-year-old male who underwent a fasciotomy and carpal tunnel release for compartment syndrome of the volar compartment of the forearm.