Clinical
Case Report
Quantifiable Soft Tissue Assessment Prompted Immediate Fasciotomy When Clinical Findings Were Inconclusive
Objective
Case Presentation
A 35-year-old male presented to the Emergency Department at midnight after a bicycle fall. On examination, both forearms were swollen; the right forearm was notably firm with stiff wrists and fingers.
Sensory reports were inconsistent. No other major injuries were reported.
Solution
Measurements
To support decision-making, non-invasive soft tissue compressibility measurements were performed using the Compremium Quantis ST device on both forearms.
The computed CP Value is the percentage change in compartment thickness between low and high applied pressures.
Timeline illustrating the patient’s course from bicycle accident to emergency evaluation, orthopedic review, serial soft-tissue compressibility measurements using Compremium Quantis ST, and ultimate fasciotomy.
The right forearm demonstrated markedly reduced compressibility compared to the left, aligning with the initial clinical assessment.
Result
Outcome & Conclusion
Clinical findings and low compressibility measurements indicated evolving acute compartment syndrome in the right forearm. Quantis ST clarified laterality, identifying significantly higher risk on the right despite bilateral swelling. This enabled targeted fasciotomy and avoided prophylactic surgery on the left, preventing irreversible tissue damage and systemic complications.
This case was presented at OTA 2025 by Andrew H. Schmidt, MD Chief Orthopedic Surgery Hennepin Healthcare Minneapolis, MN, USA
