Delayed diagnosis of Post Traumatic Deltoid Compartment Syndrome in Rural Uganda: A Case Report

Background Acute compartment syndrome (ACS) of the deltoid muscle is an exceptionally rare condition, typically associated with fractures or crush injuries. In low-resource settings, the lack of intracompartmental pressure monitoring devices makes diagnosis purely clinical and challenging, often leading to delays in management. Case Presentation : A 56-year-old male, Ugandan, who presented with severe, unremitting right shoulder pain and swelling days after a road traffic accident. Despite the absence of a fracture on radiography, physical examination revealed a tense, non-compressible swelling of the deltoid compartment with pain exacerbated by passive stretch. Based on clinical, a diagnosis of right deltoid compartment syndrome was made. An emergency fasciotomy was performed under procedural sedation using a modified V-shaped incision. Intraoperative findings included a large, organized hematoma within the muscle belly. The patient had an uneventful postoperative recovery with preservation of deltoid function. Conclusion This case highlights the critical importance of maintaining a high index of suspicion for ACS in patients with shoulder trauma, even without bony injury. It further demonstrates that in resource-constrained environments, successful limb salvage can be achieved through adaptive surgical strategies, such as bedside fasciotomy under sedation and the use of extensile incisions for adequate decompression.