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

Abstract

Introduction: 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.

Case report: 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.

Conclusion: 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.