Acute Compartment Syndrome of the Hand Following Multiple Metacarpal Fractures: Current Concepts.

Metacarpal fractures are among the most common injuries seen in the emergency department, accounting for 17.2% of all adult fractures and more than 30% of all hand injuries. The majority of these cases are stable, and conservative treatment involving closed reduction and immobilization typically yields good clinical and functional outcomes. However, acute compartment syndrome (ACS) of the hand is a critical condition that can result in irreversible changes to the neurovascular supply, leading to ischemia, permanent loss of hand function, or even amputation. The purpose of this study is to present two patients with multiple metacarpal fractures following high-energy trauma who developed hand compartment syndrome (HCS), emphasizing the need for heightened suspicion of this injury among emergency department physicians to ensure prompt diagnosis and treatment. We strongly recommend hospitalization for patients with multiple metacarpal fractures in cases of high-energy trauma, particularly if they lack the ability to obtain prompt follow-up or return to the emergency department, to closely monitor the hand for potential development of HCS.