Diagnosis of acute compartment syndrome following regional anaesthesia

Summary A 54‐year‐old female required open reduction and internal fixation of a left sided distal radius and ulnar fracture. Due to suffering from a concurrent chest infection and significant chronic obstructive pulmonary disease, she underwent the procedure using regional anaesthesia. The operation was completed without incident using an axillary brachial plexus nerve block. Following this, the patient developed severe forearm pain in the post‐anaesthetic recovery unit despite otherwise dense sensorimotor block in her arm. A diagnosis of iatrogenic compartment syndrome was made secondary to plaster cast immobilisation. The symptoms were alleviated by releasing the cast. The patient subse quentlymade an uncomplicated recovery. This case highlights how it is possible to diagnose acute compartment syndrome in the presence of working regional anaesthesia.