Risk factors:
(1) intravenous or intra-arterial injection into the hand or wrist
(2) complications of an arterial line at the wrist (radial line)
(3) arthrodesis of the wrist
(4) gunshot wound to the hand
(5) crush injury to the hand
(6) wrist fracture, especially with an overly tight cast
(7) compartment syndrome in forearm
(8) severe hand burn
Clinical findings:
(1) tense, swollen hand
(2) pain
(3) loss of sensation
(4) raised pressure in 1 or more interosseous compartments
Fasciotomy can reduce the pressure and risk for complications.
Complications:
(1) reduced perfusion, which can result in ischemia
(2) neurologic deficit
(3) muscle necrosis
(4) muscle contractures
(5) infection
(6) necrosis and amputation, usually of fingers
Reasons for poor outcome:
(1) patient obtunded
(2) delay in diagnosis and management
