Hand and upper extremities

A motorcyclist is brought to the trauma bay after crashing into a parked pick-up truck. He is alert, oriented, and hemodynamically stable. The patient has no intrathoracic or abdominal injuries. He does have extensive abrasions and bruises of his upper extremities, although radiologic evaluation demonstrates no skeletal fractures or dislocation. However, over of the course of 3 hours, the patient complains of increasing numbness and paresthesia of the left forearm. On physical examination, the involved extremity is swollen and very tense, with tenderness over the forearm musculature and paresthesia confirmed over the distribution of the median and ulnar nerves. The patient has a very strongly palpable radial pulse. Which of the following should be the management at this time? (A) Application of a sequential compression garment (B) Elevation of the involved extremity and artenography (C) Three-compartment fasciotomy (D) Venous Doppler studies (E) Repeated extremity x-rays