Passive Stretch Test

Test, Exam and Sign Description

Passive extension of fingers creates stretching of the flexor muscles (double arrow). If the muscle is ischemic stretching causes severe pain. Pain in area of distal radius fracture (single arrow) is related to fracture tenderness not ischemia secondary to compartment syndrome.

If passive extension of flexor muscles causes severe pain, the muscle is ischemic
Pain in the area of a distal radius fracture is related to fracture tenderness and not ischemia

Presentation Photos and Related Diagrams

$Passive extension of fingers creates stretching of the left flexor muscles (double arrow). If the muscle is ischemic stretching causes severe pain. Pain in area of distal radius fracture (single arrow) is related to fracture tenderness not ischemia secondary to compartment syndrome.$
Passive extension of fingers creates stretching of the left flexor muscles (double arrow). If the muscle is ischemic stretching causes severe pain. Pain in area of distal radius fracture (single arrow) is related to fracture tenderness not ischemia secondary to compartment syndrome.
$Passive extension of fingers creates stretching of the right flexor muscles. If the muscle is ischemic stretching causes severe pain. Pain in area of distal radius fracture (single arrow) is related to fracture tenderness not ischemia secondary to compartment syndrome.$
Passive extension of fingers creates stretching of the right flexor muscles. If the muscle is ischemic stretching causes severe pain. Pain in area of distal radius fracture (single arrow) is related to fracture tenderness not ischemia secondary to compartment syndrome.

Definition of Positive Result

If passive extension of flexor muscles causes severe pain, the muscle is ischemic

Definition of Negative Result

Passive extension of the flexor muscles does not cause pain out of proportion to the physical exam - pain in the area of a distal radius fracture is related to fracture tenderness and not ischemia.

Comments and Pearls

Pain is the major sign of compartment syndrome.

Diagnoses Associated with Tests, Exams and Signs

COLLES' FRACTURE

DISTAL RADIUS GROWTH PLATE FRACTURE (SALTER II )

SCAPHOID FRACTURE

References

1. Eaton RG Green WT: Volkmann's ischemia: A volar compartment syndrome of the forearm. Clin Orthop Rel Res 113:58, 1975

2. Gelberman RH, Garfin SR, Hergenroeder PT, Mubarak SJ, Menon J. Compartment syndromes of the forearm: diagnosis and treatment. Clin Orthop Relat Res 1981;161:252–261.

3. Leversedge FJ, Moore TJ, Peterson BC, John G. Seiler JG. Compartment syndrome of the upper extremity. J Hand Surg 2011;36A:544–560