A Missed Bilateral, Acute Anterior Exertional Compartment Syndrome of the Leg

Abstract

A 26-year-old male athlete presented to our hospital with bilateral leg pain after intense training. He had a history of transient numbness and pain with rigorous exercise but this time pain persisted and drop foot developed. Unfortunately, the diagnosis of acute exertional compartment syndrome was delayed due to late presentation of the patient in our department. He underwent three consecutive surgeries for decompression and debridement. At 13 months follow-up, he is ambulatory with bilateral ankle-foot orthosis. This case presents a bilateral, acute anterior exertional compartment syndrome of the leg and highlights the need for high clinical suspicion and early treatment of the acute exertional compartment syndrome.

Association Between Intracompartmental Pressures in the Anterior Compartment of the Leg and Conservative Treatment Outcome for Exercise-Related Leg Pain in Military Service Members

“…This is a rare, but potentially devastating condition, described in several case reports. 11 , 12 , 13 …”

“…Nevertheless, ICP measurements are still performed as part of standard care to determine a possible indication for early surgical treatment and to estimate the risk of developing an acute on chronic compartment syndrome. 11 , 12 , 13 However, the invasive nature of ICP measurements is associated with a risk of (asymptomatic) hematoma formation and the possibility to penetrate nerves or arteries. 14 , 15 Therefore, the need to measure ICP prior to conservative treatment for service members suspected of ant-CECS should be evaluated.…”

A case report of delayed treatment of acute exertional osteofascial compartment syndrome in the anterior compartment of the calf

“…Assessment of chamber pressure is helpful in determining the diagnosis, especially in patients with unresponsive diseases. [ 15 ]…”

“…Assessment of chamber pressure is helpful in determining the diagnosis, especially in patients with unresponsive diseases. [15] The exact pathophysiological mechanisms of acute exertional OCS remain unclear. [16][17][18][19] During exercise, it has been reported that muscle volume can increase by up to 20% and that hydrostatic pressure in tissues increases due to poor compliance of the muscle compartment.…”