Acute isolated lateral compartment syndrome of the leg after a noncontact sports injury

Abstract

Compartment syndrome of the leg typically affects the anterior compartment or multiple compartments and can be traumatic or exertional (chronic) in nature. Isolated lateral (peroneal) compartment syndrome of the leg is a less typical and lesser-known condition that can potentially escape diagnosis if not considered in the workup of a painful leg. This article presents a case of isolated lateral compartment syndrome of the leg without gross muscle rupture or hematoma. The patient presented 21 hours after injury while playing soccer. Isolated lateral compartment syndrome was diagnosed based on history, physical examination, and a compartment pressure measurement of 130 mm Hg. Emergent surgical decompressive fasciotomy was performed. The peroneal longus and brevis muscle tissue was not lost. Superficial peroneal nerve sensation, which was initially impaired, was recovered at 1 month postoperatively. The patient recovered and was able to participate in sports again by 2 months postoperatively.