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pain out of proportion to injury
97%
2277/2358
pale appearance of the foot
0%
8/2358
loss of the ability to move the toes
1%
16/2358
decreased sensation in the foot
2%
40/2358
decreased pulses in the foot
7/2358
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The Willis reference states “the single most important symptom of impending compartment syndrome is pain out of proportion to the injury." This symptom requires a conscious patient. Most children requiring a reduction for a displaced upper or lower extremity fracture will become comfortable soon after the reduction has been completed. Children requiring frequent analgesia or complaining loudly about pain should be examined very carefully for possible compartment syndrome.” The key wording in this question is “earliest indicator”. Pulselessness, paralysis, pallor, and parasthesias are all late indicators. The Willis article also lists the most reliable signs of a developing compartment syndrome as severe pain with passive stretching of the involved compartment, pain with palpation of the involved compartment, sensory disturbances
4.4
(29)
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