Compartment syndrome of the forearm and hand: a case report.

A severe compartment syndrome, involving all muscles of the forearm and hand, developed in a 25-year-old man following an erroneous injection of hypertonic saline for intravenous regional anesthesia. The treatment was complete fasciotomy of the forearm and hand musculature. The release of the hand musculature consisted of a longitudinal incision over the thenar and hypothenar muscles and a wide incision to expose the dorsal interossei. Release of the volar intrinsics included palmar fasciectomy. In this case, there was a marked toxic response to the injury in the form of disorientation, fever, leucocytosis, and urinary elevation of muscle degradation products.