Bilateral acute-on-chronic exertional lateral compartment syndrome of the leg: a case report and review of the literature.

Abstract

We report a previously undescribed case of bilateral acute exertional compartment syndrome of the lateral compartment arising from pre-existing chronic exertional compartment syndromes. A 21-year-old football player had a 1-year history of bilateral chronic exertional compartment syndrome. One day after practice his usual symptoms progressed instead of abated and he presented at 3:00 AM with bilateral acute lateral compartment syndromes. His lateral compartment pressures were > 100 mm Hg. Emergency surgical releases were performed and the patient recovered well with full return to competitive football in 4 weeks. No prior case of acute-on-chronic exertional compartment syndrome of the lateral compartment has been reported. In addition, this is a case of bilateral acute exertional compartment syndrome. The literature is reviewed with discussion of differential diagnosis, distribution, pathophysiology, and treatment of exertional compartment syndrome. Failure to recognize and emergently treat progression of a chronic to an acute exertional compartment syndrome can be devastating.