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This report presents an unusual ACS case after non-displaced fractures, challenging traditional risk factors. A healthy 4-year-old girl developed severe forearm pain, swelling, absent radial pulse, delayed capillary refill, and cold digits 12 hours after a fall. Radiographs showed non-displaced proximal ulna and distal radius fractures. Emergency fasciotomy was performed to preserve limb function, emphasizing early recognition and clinical suspicion.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/acute-compartment-syndrome-following-non-displaced-proximal-ulnar-and-distal-radial-fractures-in-a-four-year-old-girl-case-report/418713/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/acute-compartment-syndrome-following-non-displaced-proximal-ulnar-and-distal-radial-fractures-in-a-four-year-old-girl-case-report/418713.png","ImageObject",300,407,{"name":92,"@type":93},"Alex Sinclair","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What makes acute compartment syndrome (ACS) dangerous in children?","Question",{"text":112,"@type":113},"ACS is a limb-threatening emergency caused by elevated interstitial pressure in a closed compartment, leading to decreased tissue perfusion and ischemia. If not recognized quickly, it can result in permanent disability.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why does this case challenge traditional ACS risk factors?",{"text":117,"@type":113},"The report describes ACS occurring after non-displaced fractures, even though ACS is usually associated with displaced fractures, crush injuries, or high-energy trauma. This highlights that clinicians should not rely on fracture type or mechanism alone.",{"name":119,"@type":110,"acceptedAnswer":120},"What is the basis for diagnosing ACS in this context?",{"text":121,"@type":113},"Diagnosis is primarily clinical, using findings such as severe pain, pain with passive movement, swelling, paresthesia, and diminished pulses. Ancillary investigations may assist when findings are equivocal, especially in very young children.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},418713,1790766495,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},1099523882182,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Case Report J Med Cases. 2026;17(1):37-40  \nAcute Compartment Syndrome Following Non-Displaced Proximal Ulnar and Distal Radial Fracturesin a Four-Year-Old Girl  \nKhalid Aloqeelya, Amal Yousifb, d, Fatima Aljaziric  \nAbstract  \nAcute compartment syndrome (ACS) is a rare but limb-threatening emergency in children, usually associated with displaced fractures, crush injuries, or high-energy trauma. Prompt recognition and fasciotomy are essential to prevent permanent disability. An unusual case of ACS after non-displaced fractures is presented, challenging traditional risk factors. A healthy 4-year-old girl presented 12 h after a 2-m fall with severe forearm pain, swelling, an absent radial pulse, delayed capillary refill (3-4 s), and cold digits. Radiographs showed non-displaced proximal ulna and distal radius fractures. Emergency fasciotomy was performed based on clinical findings of ACS. ACScan occur in children after non-displaced fractures, even without conventional risk factors. Clinicians should rely on careful neurovascular assessment and clinical suspicion rather than fracture type or mechanism alone. Early recognition and surgical intervention are critical topreserve limb function.  \nKeywords: Acute compartment syndrome; Non-displaced fractures; Early recognition; Intervention; Children  \nIntroduction  \nAcute compartment syndrome (ACS) is a medical emergency characterized by elevated interstitial pressure within a closed osteofascial compartment, leading to decreased tissue perfusion and ischemia [1]. The pathophysiological cascade typical-  \nManuscript submitted October 14, 2025, accepted December 12, 2025 Published online December 24, 2025  \naDepartment of General Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia  \nbDepartment of Emergency Medicine-Pediatric Emergency Unit, King Saud University Medical City, Riyadh, Saudi Arabia  \ncPediatric Emergency Department, Maternity and Children Hospital, Dammam, Saudi Arabia  \ndCorresponding Author: Amal Yousif, Department of Emergency MedicinePediatric Emergency Unit, King Saud University Medical City, Riyadh, Saudi  \nArabia. Email: [dr.amalyousif@gmail.com](dr.amalyousif@gmail.com)  \ndoi: [https://doi.org/10.14740/jmc5223](https://doi.org/10.14740/jmc5223)  \nly begins with edema or bleeding in a fixed-volume compartment, raising venous and tissue pressure. When compartment pressure exceeds capillary perfusion pressure, muscle and nerve ischemia ensue [1]. Although this model presents a plausible, linear cascade of events, it is important to recognize that more complex mechanisms for this pathophysiology have also been described in the literature [2] .  \nIn the upper extremity, ACS involves several anatomical considerations. The forearm contains three main compartments: the volar compartment, the dorsal compartment, and the mobile wad (brachioradialis, extensor carpi radialis longus, and brevis), which primarily contains muscles involved in elbow flexion and wrist extension. The hand alone has ten distinct fascial compartments [1] .  \nFractures are the principal cause of ACS [3, 4], although iatrogenic causes have also been reported [5] . Atraumatic causes including hereditary angioedema, cellulitis, and osteomyelitis have also been reported [4, 6-9] . The incidence is fortunately rare, affecting 0.3% of pediatric patients after trauma [10] . The median age at presentation is 12 years, with girls accounting for 20% of cases compared to boys [11] . The upper limb is involved in 40% of cases compared to the lower limb [12], and the hand is affected in 35% of cases compared to the forearm [4] .  \nSupracondylar fracture (SCF) is classically associated with pediatric ACS, most often involving the volar forearm compartment, but its incidence is still only 0.1-0.3%[13, 14] . Reported risk factors include male sex, high-energy trauma, and concomitant humeral and forearm fractures [15, 16] .  \nDiagnosis of ACS is primarily clinical, based on findings such as severe pa","cbCaiomDcHupepAa","https://ap.wps.com/l/cbCaiomDcHupepAa","pdf",724432,"English","# Abstract\n# Introduction\n## Pathophysiology and anatomical considerations\n## Causes and incidence\n## Diagnosis in children\n## Prognosis and literature gap\n# Case Report","[{\"question\":\"What makes acute compartment syndrome (ACS) dangerous in children?\",\"answer\":\"ACS is a limb-threatening emergency caused by elevated interstitial pressure in a closed compartment, leading to decreased tissue perfusion and ischemia. If not recognized quickly, it can result in permanent disability.\"},{\"question\":\"Why does this case challenge traditional ACS risk factors?\",\"answer\":\"The report describes ACS occurring after non-displaced fractures, even though ACS is usually associated with displaced fractures, crush injuries, or high-energy trauma. This highlights that clinicians should not rely on fracture type or mechanism alone.\"},{\"question\":\"What is the basis for diagnosing ACS in this context?\",\"answer\":\"Diagnosis is primarily clinical, using findings such as severe pain, pain with passive movement, swelling, paresthesia, and diminished pulses. Ancillary investigations may assist when findings are equivocal, especially in very young children.\"}]","Acute Compartment Syndrome Following Non-Displaced Proximal Ulnar and Distal Radial Fractures in a Four-Year-Old Girl - Case Report | PDF",1790614070]