JM: CASE REPORT Spontaneous Forearm Compartment Syndrome in a Boy With Hemophilia A: A Therapeutic Dilemma. Eplasty

Objective: We present the case of a 14-year-old Factor VIII-deficient patient with no history of trauma, who developed acute spontaneous compartment syndrome of the volar forearm. We also suggest a treatment strategy. Methods: Fasciotomy with hematoma evacuation and ipsilateral carpal tunnel release was performed, and the wound was closed with vascular loops in “Jacob’s ladder ” fashion. Factor infusions were con-tinued overnight. Results: The volar forearm compartment was successfully decom-pressed, and the patient’s coagulopathy was managed with appropriate clotting factors. Conclusions: Hemophilic patientswarrant special consideration andmultispecialty care; with replenished coagulation factors and timely surgical decompression, they can expect satisfactory recovery of muscular and neurological function. Compartment syndrome is a serious condition that occurs when perfusion pressure falls below tissue pressure within a closed compartment. This can result from extrinsic forces, such as a tight cast, or intrinsic forces such as excessive interstitial fluid pressure.1 Left untreated, neurovascular compromise may lead to permanent muscle and nerve damage, limb loss, rhabdomyolysis, and death.1 While most reported cases are associated wit