Acute Exertional Compartment Syndrome Research Articles

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

Acute exertional osteofascial compartment syndrome (OCS) is a rare cause of lower-leg pain and is often associated with delayed diagnosis, which can lead to irreversible muscle and nerve damage. A 23-year-old man presented with acute-onset anterior calf pain and ankle dorsiflexion after hiking. The patient's pain was initially diagnosed as muscle strain at a county hospital, but was eventually diagnosed as OCS at our hospital 8 days after the injury. This case presents several challenges in the diagnosis and treatment phases. Three surgeries were performed in total. On the day after admission (9 days after injury), fasciotomy was performed, followed by vacuum sealing drainage (VSD). Six days after the first surgery, necrotic muscle debridement was performed and VSD was reperformed. Ten days after the second surgery, the covering foam material was removed and the incision was sutured. Satisfactory postoperative results were achieved. The erythrocyte sedimentation rate, C-reactive protein level, and white blood cell count were within normal ranges. The skin healed well, and nerve damage and muscle strength improved significantly 3 months after surgery. OCS in the absence of trauma or fracture is rare, but treatment delays can have devastating consequences. Acute nontraumatic OCS requires prompt diagnosis and surgical intervention to prevent adverse outcomes. VSD is an effective surgical treatment for this disease.

Conservative treatment of non-displaced C-type malleolar fractures for high-risk patients

Foot compartment syndrome is a serious potential complication of foot crush injury, fractures, surgery, and vascular injury. An acute compartment syndrome isolated to the medial compartment of the foot after suffering an ankle sprain is a rare complication.We report the case of a 31-year-old man who developed a medial foot compartment syndrome after suffering a deltoid ligament rupture at ankle while playing football. The patient underwent a medial compartment fasciotomy with resolution of symptoms.Compartment syndromes of the foot are rare and have been reported to occur after severe trauma. But, there are some reports in the literature of acute exertional compartment syndrome. In our case, the compartment syndrome appeared after an ankle sprain without vascular injuries associated.

Chemotherapy and extreme exercise: A potentially dangerous combination

Acute exertional compartment syndrome of the thighs is extremely rare. It should be considered in patients who present with myalgia and swelling after vigorous exercise. We present a case of a 35-year-old female athlete with breast cancer who had received one cycle of chemotherapy. The patient presented with diffuse myalgias in her thighs after an exercise session. She was diagnosed with chemotherapy induced compartment syndrome of the bilateral thighs with resultant rhabdomyolysis and acute kidney injury. She required continuous venovenous hemodialysis. The patient suffered a cardiac arrest and could not be resuscitated. This case draws attention to the potential myotoxocity of certain chemotherapeutic agents. It also demonstrates acute compartment syndrome as a rare but devastating consequence of extreme physical training associated with certain chemotherapeutic agents. As many of our patients are adopting vigorous exercise routines, it is important for physicians to be aware of acute exertional compartment syndrome, as it necessitates a high degree of clinical suspicion.

Chemotherapy and extreme exercise: A potentially dangerous combination

Acute exertional compartment syndrome of the thighs is extremely rare. It should be considered in patients who present with myalgia and swelling after vigorous exercise. We present a case of a 35-year-old female athlete with breast cancer who had received one cycle of chemotherapy. The patient presented with diffuse myalgias in her thighs after an exercise session. She was diagnosed with chemotherapy induced compartment syndrome of the bilateral thighs with resultant rhabdomyolysis and acute kidney injury. She required continuous venovenous hemodialysis. The patient suffered a cardiac arrest and could not be resuscitated. This case draws attention to the potential myotoxocity of certain chemotherapeutic agents. It also demonstrates acute compartment syndrome as a rare but devastating consequence of extreme physical training associated with certain chemotherapeutic agents. As many of our patients are adopting vigorous exercise routines, it is important for physicians to be aware of acute exertional compartment syndrome, as it necessitates a high degree of clinical suspicion.

Acute Exertional Compartment Syndrome in a Young Amateur Soccer Player: A Case Report.

We present a case of acute compartment syndrome of the lateral compartment of the lower leg, caused by strenuous eccentric exercise. The diagnosis can be made based on clinical findings, but ultrasound and MRI can be useful in recognizing this rare form of compartment syndrome.

Isolated medial foot compartment syndrome after ankle sprain

Foot compartment syndrome is a serious potential complication of foot crush injury, fractures, surgery, and vascular injury. An acute compartment syndrome isolated to the medial compartment of the foot after suffering an ankle sprain is a rare complication. We report the case of a 31-year-old man who developed a medial foot compartment syndrome after suffering a deltoid ligament rupture at ankle while playing football. The patient underwent a medial compartment fasciotomy with resolution of symptoms. Compartment syndromes of the foot are rare and have been reported to occur after severe trauma. But, there are some reports in the literature of acute exertional compartment syndrome. In our case, the compartment syndrome appeared after an ankle sprain without vascular injuries associated.

An Unusual Complication of Weightlifting: A Case Report

Acute exertional compartment syndrome is an uncommon illness that occurs after a period of strenuous exercise. We present a case of acute exertional compartment syndrome of the bilateral supraspinatus muscles after weight lifting. The diagnosis was made in the emergency department and the patient subsequently underwent successful decompressive fasciotomies of both compartments. We highlight the unusual presentation of this case and the approach to make the diagnosis.

Acute Bilateral Exertional Lateral Leg Compartment Syndrome with Delayed Presentation: A Case Report.

Acute compartment syndrome is defined as an increased pressure within a closed fascial space leading to reduced capillary perfusion that is inadequate for tissue viability1. Compartment syndrome of the lower leg can be classified by location (lateral, anterior, deep posterior, or superficial posterior), chronicity (acute or chronic), and etiology (traumatic or exertional). Exertional compartment syndrome has been well described in the orthopaedic literature; it is usually chronic in nature and does not present emergently2,3. Typically, acute compartment syndrome of the lower leg affects the anterior compartment and is caused by trauma; it rarely occurs bilaterally4-8. We present a unique case of acute exertional compartment syndrome with a delayed presentation of four days after the inciting event. The patient was informed that data concerning this case would be submitted for publication, and he provided consent. A forty-three-year-old man presented to the emergency department (ED) with severe bilateral lower-extremity (BLE) pain, approximately twenty-four hours after a two-mile run. Midway through the run, he had experienced “shooting pains” along the lateral calves that radiated up the thighs to both buttocks, with resulting tightness, warmth, swelling, and erythema of both lower extremities. He denied any trauma, twisting, or falling. All of the symptoms were worse on the left side, but both legs were symptomatic. The treating ED physicians found that the patient had no pain with passive range of motion of either lower extremity at the foot, ankle, knee, and hip; had minimal paresthesias on the dorsum of the left foot; and had a positive bilateral straight leg raise test. The patient was diagnosed with sciatica and was discharged. The patient returned to the ED twenty-four hours later with worsening pain, increased bilateral foot swelling, and inability to walk. On examination, the blood pressure …

Acute exertional paraspinal compartment syndrome

Acute exertional paraspinal compartment syndrome

Acute exertional medial compartment syndrome of the foot after playing basketball

Compartment syndrome of the foot is an uncommon event. The most common cause of compartment syndrome of the foot is a crush injury. Exceedingly rare is acute compartment syndrome of the foot occurring in the absence of trauma. We describe the clinical scenario involving a 23-year-old healthy male who developed acute exertional compartment syndrome isolated to the medial compartment of the foot after playing basketball. The patient had no evidence of injury nor trauma, and the diagnosis was made based on physical exam, magnetic resonance imaging (MRI), and compartment pressure measurements. The patient did undergo successful fasciotomy on the day of presentation to the emergency department and has since completely recovered. We found four cases reported in the literature of acute exertional medial compartment syndrome of the foot in the absence of trauma or injury. This is the second case reported after playing basketball, while the others occurred after aerobics, a long distance run, and football. The most recent case was reported by Miozzari et al. [Am J Sports Med. 36(5):983-6, 2008] and involved a marathon runner who developed an isolated medial compartment syndrome of the foot. We would like to increase awareness of this uncommon clinical presentation in the absence of trauma and present the dramatic radiographic findings.

Acute Exertional Lumbar Paraspinal Compartment Syndrome

A case report and review of the literature. To report a rare case of paraspinal compartment syndrome that presented a diagnostic challenge. Paraspinal compartment syndrome is a rare condition defined as increased pressure within a closed fibro-osseous space, resulting in reduced blood flow and tissue perfusion in that space. The reduced perfusion causes ischemic pain and irreversible damage to the tissues of the compartment if unrecognized or left untreated. A 20-year-old African-American man presented with 2 days of new-onset progressive back pain after repetitive lifting of 235 lbs in a deadlift exercise. The patient had significantly tender lumbar paraspinal muscles, was unable rise from a supine position, and had severe pain with attempted active rolling or sitting. Findings of supine radiographs were normal. Findings of initial laboratory investigations were consistent with rhabdomyolysis and acute kidney injury. Despite aggressive hydration and narcotic analgesia, the patient's creatinine kinase and myoglobin continued to rise and his pain continued to worsen. Computed tomography of the spine revealed enlarged paraspinal musculature and decreased enhancement bilaterally. Gadolinium-enhanced magnetic resonance imaging of the spine showed increased T2 signal and paraspinal muscle edema with areas of decreased contrast uptake, consistent with ischemia and necrosis. Compartment pressures measured 78 mm Hg on the left and 26 mm Hg on the right. Because hydration and analgesia had failed, the patient was taken urgently to the operating room for bilateral paraspinal fasciotomies with delayed closure. His symptoms and rhabdomyolysis then resolved during the next 2 days. The diagnostic challenge presented by this case, especially considering the rarity of paraspinal compartment syndrome, indicates the need for a high index of suspicion in the appropriate setting.

Acute Exertional Compartment Syndrome of the Forearm

Acute Exertional Compartment Syndrome of the Forearm

Acute exertional compartment syndrome in the setting of anabolic steroids: An unusual cause of bilateral footdrop

Acute exertional compartment syndrome is the result of muscle ischemia within a tight fascial compartment. We report a 22-year-old boxer, with recent intake of anabolic steroids, who developed acute exertional compartment syndrome of the lower legs following an assault from which he had to run away. He presented with bilateral footdrop. Nerve conduction studies (NCS) and electromyography (EMG) were consistent with bilateral deep and superficial peroneal neuropathies, but magnetic resonance imaging (MRI) demonstrated hemorrhagic necrosis of the pretibial muscles. This case illustrates that the differential diagnosis for footdrop includes not only central and peripheral nervous system and muscle causes, but also compartment syndromes.

Acute Exertional Compartment Syndrome Of The Superficial Posterior Compartment Without Direct Trauma Misdiagnosed As Deep Vein Thrombosis: A Case Report

Acute Exertional Compartment Syndrome Of The Superficial Posterior Compartment Without Direct Trauma Misdiagnosed As Deep Vein Thrombosis: A Case Report

Acute exertional compartment syndrome in an athlete

Acute exertional compartment syndrome is a rare condition, associated with strenuous, unaccustomed exercise. This report describes its onset in a professional footballer during a regular training session. It is often diagnosed late due to lack of awareness and patient stoicism. We illustrate the consequences of delay and reinforce the need for prompt and decisive fasciotomy if complications are to be avoided.

Acute exertional peroneal compartmental syndrome following prolonged horse riding

Compartment syndrome is defined as a condition in which high pressure within a closed fascial space reduces capillary blood perfusion below a level necessary for tissue perfusion. Compartment syndromes most commonly occur in the lower leg and forearm, though they have been described as occurring in the thigh, buttock, hand, foot and upper arm. Exertional compartment syndrome (ECS) is a well recognised clinical entity which can have an acute or chronic presentation. It is characterised by exercise induced compartmental pain and swelling, which is usually relieved by rest. We report for the first time, a case of acute exertional peroneal compartment syndrome following prolonged horse riding in a young patient, which progressed to a complete compartmental syndrome.

Acute exertional compartment syndrome of the medial foot

A review of compartment syndrome, both acute and chronic, is presented. The pathophysiology, anatomy, diagnosis, and treatment are presented in relation to a unique case report. The case is one of acute exertional compartment syndrome of the medial foot treated by fasciotomy. This condition is uncommon in both its nature and location.

Acute exertional anterior compartment syndrome in an adolescent female

Acute compartment syndromes usually occur as a complication of major trauma. While the chronic exertional anterior tibial compartment syndrome is well described in the sports medicine literature, reports of acute tibial compartment syndromes due to physical exertion, or repetitive microtrauma, are rare. The case of an adolescent female who developed an acute anterior compartment syndrome from running in a soccer game is described in this report. Failure to recognize the onset of an acute exertional compartment syndrome may lead to treatment delay and serious complications. Whereas the chronic exertional anterior compartment syndrome is characterized by pain that diminishes with the cessation of exercise, the onset of the acute exertional anterior compartment syndrome is heralded by pain that continues, or increases, after exercise has stopped. Compartment pressure measurement confirms the clinical diagnosis and helps guide treatment. True compartment syndromes require urgent fasciotomy.

Late presentation of a ruptured iliac aneurysm to a trauma department

Superficial posterior compartment syndromes are very rare. Clinically, diagnosis can be difficult because the signs and symptoms are less obvious than those of the anterior or deep posterior compartments. This case illustrates the importance of an awareness of this condition; we know of several similar cases where a torn muscle has been misdiagnosed as a deep vein thrombosis and the patient has been anticoagulated. This has caused further bleeding from the muscle giving rise to increased compartment pressure. This report serves as a good illustration that the compartments act as individual units and that pressure is not transmitted between them. Barnes M. R., Gibson M. J., Scott I. et al. (1985) A technique for the long-term measurement of intra-compartmental pressure in the lower leg. J. Biomed. Eng. 7, 35. Blandy J. P. and Fuller R. (I957) March gangrene. Ischaemic myositis of the leg muscles from exercise. J. Bone Joint Surg. 39B, 679. Kirby N. G. (/970) Exercise ischaemia in the fascial compartment of soleus. Report of a case. ]. Bone]oint Surg. 52B, 738. Mubarak S. J., Owen C. A., Garfin S. et al. (1978) Acute exertional superfidal posterior compartment syndrome. Am. ]. Sports Med. 6, 287.

Lumbar Paraspinal Compartment Syndrome

A 24-year-old man presented with severe low-back pain and paraspinal muscle spasm after exertion. Elevation in temperature, white blood cell count, serum muscle enzymes, and urine myoglobin, as well as computer tomographic evidence of paraspinal muscle edema and necrosis, were present. No etiology could be documented, and the possibility of an acute exertional compartment syndrome was entertained. Subsequently, cadaveric dis-sections indicated that the erector spinae muscles are contained within a well-developed fascial sheath. Continuous slit catheter pressure measurements within this compartment in eight healthy male subjects were subsequently carried out. These indicated a physiologic behavior similar to other known compartments for which compartment syndromes have been described. Variation in intracompartmental pressure occurred as a function of body posture, erector spinae isometric contraction, and active intra-abdominal pressurization. We suggest this patient had a paraspinal compartment syndrome and have described pressure characteristics of this compartment in normal men.