Naganuma Yasushi, Satake Hiroshi, Fukuda Norio, Takagi Michiaki
Department of Orthopedic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
Department of Orthopedic Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan.
J Orthop Case Rep. 2025 Sep;15(9):121-124. doi: 10.13107/jocr.2025.v15.i09.6038.
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.
急性前臂骨筋膜室综合征(AFCS)在儿科患者中较为罕见。由于儿科患者临床表现的多样性以及语言表达不成熟,AFCS的诊断往往具有挑战性。我们报告一例幼儿AFCS病例,该患儿表现为从远端前臂到手部的特定充血,并导致血肿形成,但无骨折。
一名2岁男孩从椅子上摔落后出现右上肢疼痛和麻痹。他没有先天性出血性疾病家族史或服用抗凝药物。其右前臂远端到手部充血,与近端前臂界限清晰。X线检查未发现任何骨折。我们诊断他为AFCS,并进行了筋膜切开术,术中发现腕管周围有逐渐形成的血肿。术后两年,他上肢无神经功能缺损迹象。
该幼儿因低能量跌倒受伤,这种情况非典型,足以提示急性骨筋膜室综合征的发病。腕部以外的充血,与近端区域界限清晰,提示外周循环障碍,是该病例最显著的体格检查发现。