Isolated Anterior Compartment Syndrome After a Bimalleolar-Equivalent Ankle Fracture in a Collegiate Football Player

Starr, Adam M.; Swan, Kenneth G.

doi:10.1177/1941738111420527

Cited by 2 publications

(4 citation statements)

References 15 publications

(23 reference statements)

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“…This combined with the multiple case reports in the literature of anterior and lateral compartment syndromes after ankle fractures make one wonder if the superior extensor retinaculum syndrome might be the initial problem with later extension of the swelling proximally as the injuries are located more distally in these patients. 3 - 6 , 9 , 10 , 14 , 17 - 19 It is possible, though, that the superior extensor retinaculum syndrome and anterior and/or lateral compartment syndromes occurred simultaneously and there were no associative effects. Further research is needed to evaluate the true incidence and natural history of ERS.…”

Section: Discussionmentioning

confidence: 99%

“…In his article, Mubarak further noted a personal, anecdotal adult case in which he encountered a necrotic extensor hallucis longus (EHL) during an approach to the tibial plafond. 17 He proposed that this is indicative of an equivalent syndrome in the adult population, but no case series has been published until this publication. Seven adult patients with distal tibial/fibular, exhibiting symptoms resembling those outlined in Mubarak’s article, are presented in this case series.…”

Section: Introductionmentioning

confidence: 99%

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Extensor Retinaculum Syndrome of the Ankle: An Adult Case Series

Carlson,

Chirongoma

et al. 2024

Foot & Ankle Orthopaedics

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Background: Extensor retinaculum syndrome (ERS) is a relatively rarely diagnosed compartment syndrome-like entity caused by elevated pressures in the tissues deep to the superior extensor retinaculum (SER). ERS is identified as out-of-proportion anterior ankle pain, pain with passive toe plantarflexion, elevated SER pressures (>40 mm Hg), and ultimately toe extension weakness and first web space numbness. Although previously described in a pediatric population, this case series is the first to our knowledge in an adult population. Methods: Seven nonconsecutive cases over 18 years from 2 surgeons are reported who underwent complete SER release for ERS either through the direct lateral approach to the fibula or the anterolateral approach to the distal tibia. All were associated with traumatic injuries including 3 bimalleolar ankle fractures, 3 tibial pilon fractures, and 1 distal tibial/fibular shaft fracture. All patients developed writhing anterior ankle pain worsened with passive toe plantarflexion. SER compartment pressures ranged from 50 to >135 mm Hg. Five cases displayed decreased first web space sensation. Results: The diminished or absent first web space sensation uniformly improved post-release. Complications included 1 patient with complex regional pain syndrome type 1, 1 patient required hardware removal, and 2 had persistent but improved first web space sensation changes. Conclusion: Clinical suspicion for possible ERS should arise after distal tibial/fibular fractures when the excruciating pain localizes to the ankle instead of the classic anterior leg muscle bellies. If pain is worsened with passive toe plantarflexion, this diagnosis should be considered. Recommended treatment involves complete release of the SER anywhere on the anterior surface between the tibia and fibula depending on the approach needed for fixation of the associated fracture. Level of Evidence: Level IV, case series.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Extensor Retinaculum Syndrome of the Ankle: An Adult Case Series

Carlson,

Chirongoma

et al. 2024

Foot & Ankle Orthopaedics

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“…He was able to return to full activity by 6 months after his repeat fasciotomy but was not offered a subsequent contract. Starr et al 33 reported a case of anterior leg compartment syndrome after a bimalleolar equivalent ankle fracture in a collegiate football player who was injured playing recreational touch football. In the present series, 1 NFL player with ACS and an associated tibial shaft fracture sustained during a preseason practice returned to full participation 89 days postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…7 There are few studies to date reporting on compartment syndrome in athletes, and most existing publications are case reports. 2,7,13,17,18,21,23,27,28,[33][34][35][36][37] Furthermore, to our knowledge, there is only 1 published case report of compartment syndrome in a National Football League (NFL) player, with this case occurring in an athlete after a fracture of a tibiofibular shaft synostosis. 14 As such, the epidemiology of lower extremity compartment syndrome among NFL players is yet to be described.…”

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confidence: 99%

Lower Extremity Compartment Syndrome in National Football League Athletes

et al. 2021

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Background: The purpose of this study was to evaluate the incidence of lower extremity compartment syndrome in National Football League (NFL) athletes and report the mechanisms of injury, methods of treatment, and subsequent days missed. We review the existing literature on lower extremity compartment syndrome in athletic populations. Hypothesis: Lower extremity compartment syndrome occurs with a low incidence in NFL athletes, and there is a high return-to-play rate after surgical management of acute compartment syndrome. Study Design: Case series. Level of Evidence: Level 4. Methods: A retrospective review of recorded cases of lower extremity compartment syndrome from 2000 to 2017 was performed using the NFL Injury Surveillance System and electronic medical record system. Epidemiological data, injury mechanism, rates of surgery, and days missed due to injury were recorded. Results: During the study period, 22 cases of leg compartment syndrome in 21 athletes were recorded. Of these injuries, 50% occurred in games and 73% were the result of a direct impact to the leg. Concomitant tibial fracture was noted in only 2 cases (9.1%) and there was only 1 reported case of chronic exertional compartment syndrome. Surgery was documented in 15 of 22 cases (68.2%). For acute nonfracture cases, the average time missed due to injury was 24.2 days (range, 5-54 days), and all were able to return to full participation within the same season. Conclusion: NFL athletes with acute leg compartment syndrome treated with surgery exhibited a high rate of return to play within the same season. Clinical Relevance: Although compartment syndrome is a relatively rare diagnosis among NFL players, team physicians and athletic trainers must maintain a high index of suspicion to expediently diagnose and treat this potentially limb-threatening condition.

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Isolated Anterior Compartment Syndrome After a Bimalleolar-Equivalent Ankle Fracture in a Collegiate Football Player

Cited by 2 publications

References 15 publications

Extensor Retinaculum Syndrome of the Ankle: An Adult Case Series

Extensor Retinaculum Syndrome of the Ankle: An Adult Case Series

Lower Extremity Compartment Syndrome in National Football League Athletes

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