Pronator Quadratus Space and Compartment Syndrome After Low-Energy Fracture of the Distal Radius: A Case Report

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Acute compartment syndrome following fracture of the distal radius occurs in less than 1% of cases, but if the diagnosis is delayed, the potential consequences may be devastating. The majority of the cases involve high-energy injuries in young patients, and increasing pain ‘‘out of proportion to the injury sustained’’ is a constant finding and constitutes the hallmark of the diagnosis. This case report describes a rare presentation of an acute compartment syndrome in the forearm and wrist after fracture of the distal radius that developed in the absence of acute pain symptoms, in an older individual, and in the context of a low-energy injury. This report of an unusual case highlights the existence of atypical presentations, discusses the potential role of the pronator quadratus space, and further emphasizes the need for vigilance even in ‘‘low-risk’’ cases of distal radius fracture. (Journal of Surgical Orthopaedic Advances 17(2):102–106, 2008)

George D. Chloros, MD, Anastasios Papadonikolakis, MD, Stuart Ginn, BS, and Ethan
R. Wiesler, MD