title: Compartment syndrome without pain!
abstract: We report the case of a young male patient who underwent intra-medullary nailing for a closed, displaced mid-shaft fracture of tibia and fibula. He was commenced on patient controlled analgesia post-operatively. A diagnosis of compartment syndrome in the patient's leg was delayed because he did not exhibit a pain response. This ultimately resulted in a below-knee amputation of the patient's leg. We caution against the use of patient controlled analgesia in any traumatised limb distal to the hip or the shoulder.
authors.affiliation: Department of General Surgery, Cork University Hospital, Ireland.
authors.forename: M J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: J
authors.initials: J
authors.lastname: Rice
authors.forename: A J
authors.initials: AJ
authors.lastname: McGuinness
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled; D000868:Anterior Compartment Syndrome / Q000175:diagnosis*; D005360:Fibula / Q000293:injuries; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D008297:Male; D013978:Tibial Fractures / Q000601:surgery*; D013997:Time Factors