Isolated Acute Lateral Compartment Syndrome in an Adolescent Athlete

Abstract

Case: A 17-year-old adolescent boy presented with anterolateral, right leg pain and numbness of his right foot 2 days after participating in football practice. He denied a traumatic event, and radiographs were negative for fracture. His imaging and physical examination raised suspicion for acute compartment syndrome (ACS). Single-incision fasciotomy with anterior and lateral compartment release was performed. The peroneus longus muscle was detached at the musculotendinous junction. The peroneus longus was then debrided and transferred to the peroneus brevis. Conclusion:Atraumatic ACS, although rare, is a diagnostic challenge. Prompt recognition of this atypical presentation is important for proper treatment.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B877).

Atraumatic Idiopathic Compartment Syndrome Requiring Emergent Fasciotomy: A Case Report and Literature Review

“…While trauma is the most common cause of ACS with an associated fracture in 69% of patients [ 6 ], a variety of atraumatic etiologies have been identified in the literature, including prolonged immobilization secondary to substance abuse, loss of consciousness, or operative procedure [ 7 - 9 ]; long-standing uncontrolled diabetes [ 10 ]; use of anticoagulation medication [ 11 ]; or an undiagnosed bleeding disorder [ 12 ]. The average time from symptom onset to diagnosis of ACS in patients without a fracture is approximately two days, similar to what was seen in the current presentation [ 13 ]. The wide variance in patient population and injury patterns complicates diagnostic algorithms, as the clinician must maintain a high degree of suspicion even in those without a fracture or high-energy mechanism [ 14 ].…”