Fractures & Trauma · NEET PG Preparation Orthopaedics
A 45-year-old male is rescued from a motor vehicle wreckage with a severely crushed right lower leg. Two hours after admission, he complains of sever…
Practice question from Fractures & Trauma (NEET PG Preparation Orthopaedics), with the correct answer and a step-by-step solution.
medium · MCQ · Q-8821B5
A 45-year-old male is rescued from a motor vehicle wreckage with a severely crushed right lower leg. Two hours after admission, he complains of severe, unrelenting pain in the calf that is out of proportion to the physical findings and is worsened by passive stretch of the toes. Pulses are intact, and capillary refill is normal. Which of the following is the most appropriate immediate diagnostic or therapeutic intervention?
- A.Reassure and administer intravenous narcotics
- B.Urgent measurement of compartment pressures or emergency fasciotomyCorrect answer
- C.Apply warm compresses and elevate the limb above the heart
- D.Order an emergency duplex ultrasound for deep vein thrombosis
Solution
The patient is presenting with classic signs of acute compartment syndrome (pain out of proportion, pain on passive stretch). Distal pulses are typically preserved until very late stages. Management requires urgent compartment pressure measurement or immediate surgical decompression via fasciotomy.
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