Acute hand pain resulting in spontaneous thenar compartment syndrome

• Published in: The American journal of emergency medicine Vol. 37; no. 3; pp. 561.e3 - 561.e4
• Main Author: Neth, Matthew R.
• Format: Journal Article
• Language: English
• Published: Philadelphia Elsevier Inc 01.03.2019; Elsevier Limited
• Subjects: Blood pressure; Bone surgery; Cell death; Compartment syndrome; Diagnosis; Digits; Emergency medical care; Fasciotomy; Fingers & toes; Firmness; Hand pain; Infections; Morbidity; Pain; Perfusion; Poikilothermia; Quality of life; Spontaneous; Thenar; Trauma; United States > US; Kalamazoo Michigan; Fasciotomy; Hand pain; Compartment syndrome; Spontaneous; Thenar
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2018.11.035

Compartment syndrome is a potentially limb-threatening disease process, leading to decreased tissue perfusion and cellular death [1]. The following presentation is believed to be the first reported case of thenar compartment syndrome, which occurred without an identifiable cause. A 67-year-old male presented with 12 h of left-hand pain, located at the base of the thumb and worsened with movement. Firmness of the thenar eminence, along with pallor, poikilothermia, and paresthesias of the first and second digits lead to the increased suspicion for compartment syndrome. The diagnosis was confirmed and successfully managed in the operating room. While relatively uncommon, clinicians should consider the diagnosis of compartment syndrome of the hand when patients present with acute hand pain. A missed or delayed diagnosis can lead to severe morbidity, which can profoundly affect patients' functional outcomes and quality of life.