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The Journal of Bone and Joint Surgery (American) 86:2041-2044 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

Subatmospheric Pressure-Induced Compartment Syndrome of the Entire Upper Extremity

A Case Report

Eric M. Bluman, MD, PhD1, Robert Z. Tashjian, MD1, Peter F. Graves, MD2 and Thomas B. Hughes, MD1

1 University Orthopaedics, 2 Dudley Street, Providence, RI 02905. E-mail address for E.M. Bluman: eric_bluman@brown.edu
2 Brown University Department of Emergency Medicine, Rhode Island Hospital, 593 Eddy Street, Davol 141, Providence, RI 02903

Investigation performed at the Departments of Orthopaedic Surgery and Emergency Medicine, Brown University School of Medicine, Providence, Rhode Island

The first 150 words of the full text of this article appear below.


   Introduction
 
We describe the case of a patient in whom a compartment syndrome developed in the upper extremity as the result of prolonged application of considerable negative pressure, a phenomenon that we have termed subatmospheric pressure-induced compartment syndrome (SAPICS). To our knowledge, this is the first reported case of a compartment syndrome that involved all compartments of the upper extremity. Our patient was informed that data concerning this case would be submitted for publication.


   Case Report
 
The entire right (dominant) upper extremity of a healthy twenty-seven-year-old man became entrapped in the 20-cm-diameter intake snorkel of an industrial vacuum machine (Fig. 1) while he was cleaning debris from a demolition site. The patient was working alone at the time of the injury and estimated that his arm was in the snorkel for approximately five minutes. After the vacuum had been turned off, there was immediate pain and paresthesias throughout the limb.


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