When assessing a patient with a suspected penetrating injury from a nail gun to the thigh, what is the most crucial aspect to observe for, indicating a developing compartment syndrome?
Localized warmth directly over the puncture site
Increased pain on passive stretch of involved muscles
Pulselessness distal to the injury site
Immediate bruising and discoloration of the overlying skin
Increased pain out of proportion to the injury, especially on passive stretch of muscles within the involved compartment, is a crucial indication of developing compartment syndrome. Paresthesia, pallor, and paralysis are also signs of compartment syndrome, but they typically appear later in the condition's progression. Pulselessness is a late and unreliable sign due to the potential for collateral circulation.
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Musculoskeletal and Wound Emergencies
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