Which is the earliest reliable sign suggestive of compartment syndrome?

Ans. is 'a' i.e., Stretch pain Clinical features of compartment syndromeo Four signs are reliable in diagnosing a compartment syndromei) Paresthesia or hypesthesia in nerves traversing the compartment(AMU 96, WB 94)ii) Pain with passive stretching of the involved muscles (stretch pain)iii) Pain with active flexion of the musclesiv) Tenderness over the compartmento Amongst these, stretch pain is the earliest sign of impending compartment syndrome. The ischemic muscles, when stretched, give rise to pain.o Passive extension of fingers (streching the fingers) produce pain in flexor compartment of forearmo Other features are Pulselessness, paralysis, Pallor and pain out of proportion to physical findingso Peripheral pulses, are present initially and disappear later. Therefore, pulse is not a reliable indicator for compartment syndrome.Stretch testo This is the earliest sign of impending compartment syndromeo The ischemic muscles, when stretched, give rise to pain.o It is possible to stretch the affected muscles by passively moving the joints in direction opposite to that of the damaged muscle actioni) Passive extension offingers produces pain in flexor compartment syndrome offorearm.ii) Dorsiflexion offoot produces pain in posterior compartment of leg.iii) Plantar flexion produces pain in the anterior compartment of leg.