TVTRAUMAVAULTCASE-BASED TRAUMA JUDGMENT
Teaching image withheldThe image will be revealed when it becomes clinically available in the case.
INTRAOPERATIVE image obtained after lower-leg fasciotomy: an open longitudinal operative wound with exposed soft tissue. The photograph confirms a fasciotomy but does not independently establish laterality, the exact compartments released, muscle viability, or the indication for surgery. teaching visual
INTRAOPERATIVE image obtained after lower-leg fasciotomy: an open longitudinal operative wound with exposed soft tissue. The photograph confirms a fasciotomy but does not independently establish laterality, the exact compartments released, muscle viability, or the indication for surgery. • TEACHING IMAGE
Extremity TraumaCrush injury to the lower leg with tibial fracture and evolving acute compartment syndromeIntermediate

Intraoperative Fasciotomy Image Review After Acute Compartment Syndrome

SCENARIO

A 29-year-old construction worker sustains a heavy crush injury to the right lower leg when trapped briefly between machinery components. Plain radiographs at the receiving trauma center show a closed tibial shaft fracture. After splinting, analgesia, and initial resuscitation, serial examinations show escalating pain despite opioids, pain with passive toe stretch, tense compartments, and worsening paresthesia. Distal pulses remain palpable. The orthopedic trauma team is urgently consulted, and the patient proceeds to the operating room for suspected acute compartment syndrome. The uploaded photograph is obtained intraoperatively after the fasciotomy and becomes available during postoperative handoff; it is not used to establish the preoperative diagnosis.

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