Kadzielski J, Bae DS
Changes in aircraft cabin pressure and its interplay with a fixed diameter fiberglass cylindrical cast and the closed air cells in waterproof cast padding may cause a transient altitude induced compartment syndrome. In this case series, 2 patients reported transient compartment syndromes that resolved with aircraft decent. As proof of concept, this work displays photographic and video evidence showing the difference in air cell volume from experimental data in a vacuum chamber as well as real-world volume changes at cruise altitude in a commercial airliner. Transient altitude-induced compartment syndromes associated with fiberglass casts using waterproof cast padding are real and surgeons and patients should be advised of this potentially devastating complication.