A 24-year-old man with a tibial fracture is suspected of having compartment syndrome. Which assessment findings most closely align with acute compartment syndrome?

Choice A reason: While pain and pallor are features of compartment syndrome, the inability to perform passive movements is not a hallmark sign. In fact, pain with passive movement is more indicative of increased intracompartmental pressure. This choice omits critical signs such as paresthesia and pulselessness, which are essential for diagnosis. Choice B reason: This option includes pain and weakness, which may be present, but again lacks the specificity of pain with passive movement and the full spectrum of neurovascular compromise. Weakness alone is not sufficient to confirm compartment syndrome, and the absence of paresthesia and pulselessness makes this choice incomplete. Choice C reason: This choice correctly lists the classic “5 P’s” of acute compartment syndrome: pain, pulselessness, paresthesia, paralysis, and pallor. These signs reflect severe neurovascular compromise due to increased pressure within the compartment. Pain is typically out of proportion to the injury and worsens with passive stretch. Pulselessness and paralysis are late findings, indicating advanced ischemia. Choice D reason: Pain with passive movement is a key early sign of compartment syndrome, but the inability to perform active movement and weakness alone do not encompass the full clinical picture. This option lacks paresthesia and pulselessness, which are critical for diagnosis.