Cause Of Lower Leg Pain 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.

Minimally invasive fasciotomy using a lighted retractor in the treatment of chronic exertional compartment syndrome.

Chronic exertional compartment syndrome can be a debilitating cause of lower leg pain that typically affects young, healthy people during a variety of aerobic activities. Conservative management has produced a poor success rate and numerous techniques for surgical decompression have been described. Many of these, however, involve blind fascial dissection which increases the risk of direct nerve injury or insufficient fascial release. We describe a novel technique of mini-open fasciotomy using a lighted retractor which enables direct visualization of the fascia and the superficial peroneal nerve using a single, small incision. By the use of a 3- to 4-cm laterally based incision, a lighted retractor with fiber-optic illumination is introduced into the subcutaneous plane and advanced distally and proximally. The retractor gently elevates the subcutaneous tissues while focusing light directly into the surgical area and a long Metzenbaum scissors is then used to release the fascia under direct vision. Fasciotomy using this technique avoids the risks of blind fascial release and is a straightforward, safe, and effective method for compartment decompression.

Chronic Lower Leg Pain in Athletes: Overview of Presentation and Management.

Athletes with chronic lower leg pain present a diagnostic challenge for clinicians due to the differential diagnoses that must be considered. We aimed to review the literature for studies on the diagnosis and management of chronic lower leg pain in athletes. A literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The PubMed, Scopus, and Cochrane library databases were searched, and articles that examined chronic lower leg pain in athletes were considered for review. Two independent reviewers conducted the search utilizing pertinent Boolean operations. Following two independent database searches, 275 articles were considered for initial review. After the inclusion and exclusion criteria were applied, 88 were included in the final review. These studies show that the most common causes of lower leg pain in athletes include medial tibial stress syndrome, chronic exertional compartment syndrome, tibial stress fractures, nerve entrapments, lower leg tendinopathies, and popliteal artery entrapment syndrome. Less frequently encountered causes include saphenous nerve entrapment and tendinopathy of the popliteus. Conservative management is the mainstay of care for the majority of cases of chronic lower leg pain; however, surgical intervention may be necessary. Multiple conditions may result in lower leg pain in athletes. A focused clinical history and physical examination supplemented with appropriate imaging studies can guide clinicians in diagnosis and management. We provide a table to aid in the differential diagnosis of chronic leg pain in the athlete.

Management and patients perspective regarding a common peroneal nerve schwannoma: a rare cause of lower leg pain in a young individual

The differential diagnosis of exercise-induced lower leg pain in young individuals is extensive and includes entities such as chronic exertional compartment syndrome, popliteal arterial entrapment syndrome, cystic adventitial disease, medial...

Endoscopic Fasciotomy of the Superficial and Deep Posterior Compartments of the Leg

Chronic exertional compartment syndrome is a rare cause of lower leg pain incurred during sports activities and typically affects young athletes who need to return to their activity level as quickly as possible. Nonoperative treatments are often unsuccessful and fasciotomy of the involved compartment is the treatment of choice. Endoscopically assisted release of the anterior and deep compartments is proven to be safe and effective. Endoscopically assisted deep posterior compartment release via an incision 1 to 3 cm behind the medial tibial border has high risk of injury to the great saphenous and perforating veins and the saphenous nerve. The purpose of this Technical Note is to describe the details of endoscopic fasciotomy of the superficial and deep posterior compartments of the leg. The operative field of this approach is away from the saphenous vein and nerve. Moreover, the tibial insertion of the soleus muscle does not need to be released to gain access to the proximal part of the deep posterior compartment.

Popliteal Artery Entrapment Syndrome.

Popliteal artery entrapment syndrome (PAES) may be implicated as a cause of lower leg pain in active individuals. Though a relatively rare syndrome, it is likely underdiagnosed. History often includes exertional lower leg pain, cramping, and/or paresthesias rather quickly relieved by rest, though examination may be benign. When suspected, imaging is recommended to assess anatomic variations versus functional entrapment of the artery in the calf. Because there are a number of diagnostic modalities available, it seems prudent to begin with noninvasive testing, such as ultrasound with Doppler and provocative maneuvers. Thereafter, advanced imaging (magnetic resonance imaging/magnetic resonance angiography) or arteriography may help identify a specific anatomic obstruction. Once confirmed, surgical exploration has historically been the treatment of choice, though less invasive interventions have been proposed. Though most patients reportedly return to high-level training, decision-making remains highly individualized. Further study of younger, active individuals with PAES will help to further define these criteria.

Unusual cause of lower leg pain

Unusual cause of lower leg pain