Delayed onset of forearm compartment syndrome: a complication of distal radius fracture in young adults.

The signs and symptoms of elevated intracompartmental pressure in the volar forearm compartment developed on a delayed basis (range 18-54 h) in the absence of constricting casts or dressings in eight limbs after high-energy intraarticular fractures of the distal end of the radius. Intracompartment pressures averaged 80 mm Hg in the six limbs tested. Despite urgent decompression and fracture fixation with delayed wound closure, final functional outcomes were compromised in seven cases, reflecting the severity of the articular injuries, and poor in one case, in which a wrist fusion was later required. If potentially serious complications are to be prevented, careful observation of these patients, often for periods of 48 h, is important. Selective recording of forearm intracompartmental pressures may be advised in at-risk patients.