Jornal de Patologia Médica e Cirúrgica
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Compartment Syndrome of the Hand: A Rare Localization with a Poor Prognosis: Two Case Reports and a Literature Review

Walid Bouziane, Jamal Karbal, Omar Agoumi, Abdelkrim Daoudi

Background: Compartment syndrome is a medical-surgical emergency. In fact, it is a "race against the clock" to reduce, as quickly as possible, the pressure inside a well-defined muscular compartment. Its development at the hand level as part of a crushing trauma is a rare localization and mainly affects the radial interosseous muscular compartment. The diagnosis of hand compartment syndrome is primarily clinical. Its classical clinical triad includes spontaneous pain, paralysis, and pain increase during passive extension. Any additional examination must not, in any sense, delay the patient's management. Ignoring this surgical emergency can cause permanent damage to the hand.

Case presentation: In this article, we will discuss our experience with two cases who presented with hand compartment syndrome after suffering numerous metacarpal fractures as a result of trauma. The treatment included a discharge dermofasciotomy, metacarpal pinning, and close hand surveillance. Excellent outcomes were seen after three months, with complete functional recovery of hand mobility.

Conclusion: The compartment syndrome in the hand is a rare localization that affects the hand's functional prognosis. Its treatment consists of two key components: discharge aponeurotomy and bone stabilization. There should be no delay in surgical treatment for this syndrome.