Compartment Syndrome — the orthopedic version of a ticking time bomb. ⏱️
And no, I’m not being dramatic. If you’ve ever seen Dr. Faisal Afridi sprint across the ER shouting “fasciotomy tray, now!” — you know what I mean.
It’s one of those emergencies you can’t afford to miss — because missing it means muscle necrosis, nerve damage, and possibly amputation.
(Don’t worry, I’ll give you a mnemonic. But first, a quick ward story.)
🏥 Real life clinical encounter
Last Eid, a 28-year-old shepherd from Zehri, Balochistan limped into our ER post-motorbike accident — left leg swollen, firm, and “just a little sore.”
“Classic shin hit,” someone mumbled.
But something didn’t sit right — the pain was out of proportion, he couldn’t move his toes, and his calf felt like a cricket bat on palpation.
I called Dr. Faisal Afridi. One look, and he said the dreaded words:
“This is compartment syndrome. We’re taking him in now.”
And thus began the urgent fasciotomy waltz. 💃🩺
🧠 The Mnemonic: 5 P’s of Compartment Syndrome
| P | Clinical Feature | Explanation |
|---|---|---|
| Pain | Out of proportion to injury | First and most important sign. Especially on passive stretch. Watch this one like a hawk. 🦅 |
| Paresthesia | Tingling, numbness | Nerve ischemia sets in fast. Patients describe it as pins and needles or electric shocks ⚡ |
| Pallor | Pale skin distal to compartment | Due to compromised arterial inflow — usually a late finding 🚨 |
| Paralysis | Weakness or inability to move the limb | Also late. If present, the clock’s already ticking fast. Call ortho. NOW. 🏃♂️ |
| Pulselessness | Absent distal pulses | Rare and very late. If you’re waiting for this one, you’re already too late ⌛ |
Common Causes of Compartment Syndrome
- Crush injuries — post-accident or earthquake trauma (thanks to Quetta’s tremor tantrums).
- Tight casts — someone got overzealous in plaster room again. 🙃
- Reperfusion injuries — post-vascular surgery, especially in trauma.
- Snake bites — especially in patients from Panjgur and Kharan. Seen it twice this year alone. 🐍
Happy learning folks! 🙂
Authored by:
Dr. Aurangzaib Qambrani
📍 Sheikh Khalifa Bin Zayed Hospital, Quetta
🩺 Departments: General Medicine, Gastroenterology, Cardiac Care Unit
📚 MBBS | PLAB | MRCP (UK)
