910 - Hidden in Plain Sight: Limb Compartment Syndrome Following Gunshot Trauma – A Case Report

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

RR

Rodolfo Rodriguez, BA

Medical Student
University of Central Florida College of Medicine
Miami, Florida, United States
CB

Cody Barbari, DO

PGY-4, Chief Resident
Memorial Healthcare
Hollywood, Florida, United States

Co-Author(s)

JD

Joanne Delgado Lebron, MD

Attending Physician
Memorial Healthcare System
Hollywood, Florida, United States

Submitter(s)

RR

Rodolfo Rodriguez, BA

University of Central Florida College of Medicine
Miami, Florida, United States

Case Diagnosis: Limb Compartment Syndrome (LCS) of the left forearm in the setting of multiple gunshot wounds and traumatic spinal cord injury.

Case Description: A 30-year-old male presents with paraplegia and complete sensory loss of the lower extremities due to multiple gunshot wounds, complicated by a T11 spinal cord injury and left forearm fractures. Following acute hospitalization, he was transferred to an inpatient rehabilitation facility for functional recovery. Throughout the rehab process, the patient complained of persistent left forearm pain, inhibiting his participation in therapies. He was evaluated by various specialties, with no major findings, yet patient continued to relate increasing pain and swelling. Following delays in obtaining appropriate workup, the left upper extremity eventually developed numbness and worsening weakness. This prompted concern for LCS and urgent surgical exploration, leading to fasciotomy and removal of necrotic muscle, with subsequent impact on rehabilitation outcomes.

Discussions: The authors’ case illustrates the unique challenges of diagnosing LCS in a rehabilitation setting, where pain and weakness may be attributed to other causes such as neurologic injury. Classic findings such as “pain out of proportion” and paresthesias can be masked in patients with spinal cord injury, delaying recognition. Untreated LCS can result in irreversible muscle necrosis, nerve damage, rhabdomyolysis, and ultimately limb loss. For physiatrists, vigilance is critical. Acute onset of focal pain, swelling, or loss of function should prompt evaluation. If not addressed in time, the associated complications create secondary impairments that inhibit functional gains, in turn requiring tailored therapy plans, patient counseling, and psychological support.

Conclusions: LCS can present subtly during rehabilitation and significantly alter recovery if not recognized in time. Physiatrists play a vital role in early recognition, interdisciplinary coordination, and adapting rehabilitation plans following treatment. This case highlights the importance of maintaining a high index of suspicion for LCS in rehabilitation patients with recent trauma.