شاب عمره ٢٢ سنة بعد كسر في عظم الساق رُكبت له جبيرة جبس قبل ٨ ساعات. يشتكي ألماً شديداً متزايداً لا يخف بالمورفين، ويزيد عند تحريك أصابع قدمه بشكل سلبي، مع تنميل. الأصابع دافئة والنبض موجود. ما الأرجح؟

A 22-year-old had a plaster cast applied to a tibial fracture 8 hours ago. He reports severe, increasing pain unrelieved by morphine, worse on passive toe movement, with numbness. Toes are warm and pulses present. What is most likely?

1. Normal post-fracture pain
2. Deep vein thrombosis
3. Compartment syndrome
4. Plaster allergy

Answer: C) Compartment syndrome. Pain out of proportion, worse with passive stretch and unrelieved by analgesia, is the earliest sign of compartment syndrome; pulses may persist until late. Loosen the cast and notify immediately.