Spontaneous Anterior Forearm Compartment Syndrome in a Healthy Postpartum Woman: A Rare Case

Acute compartment syndrome typically follows trauma, fractures, or vascular compromise, with spontaneous presentations being exceedingly rare. We report a unique case of a 37-year-old healthy Middle Eastern woman, two months postpartum, who presented with sudden swelling and pain of the right forearm without any history of trauma or systemic disease. In this patient, several postpartum-specific physiological factors may have contributed to the underlying pathophysiology. Physical examination revealed significant volar forearm swelling and ecchymosis with preserved distal pulses. Imaging studies confirmed soft tissue swelling but excluded vascular occlusion or fracture, leading to a clinical diagnosis of anterior compartment syndrome. The patient underwent an urgent fasciotomy followed by three subsequent re-explorations for wound debridement. Her postoperative recovery was favorable, and she was discharged with arrangements for outpatient rehabilitation. This case underscores the rare occurrence of spontaneous compartment syndrome in the postpartum period. It highlights the critical importance of maintaining a high index of suspicion even in the absence of classic risk factors, as early recognition and surgical intervention are paramount to preventing long-term disability.