[Compartment syndrome after impact trauma from a car bumper]

Abstract

A 67-year-old woman, having been hit in the lower leg by a car bumper in a road accident, developed a compartment syndrome in the lower leg without any bone injury. In the following weeks typical contractures of the affected muscles occurred with talipes equinus and clawfoot deformities. In addition there developed insertion tendinitis of the affected muscle groups of the anterior tibia. A year later magnetic resonance imaging (with normal radiological findings) revealed fatty degeneration and muscle fibrosis. The patient complained of pain at rest and on movement in the proximal tibia, and there was definite pain on pressure over the proximal end of the tibia. Conservative treatment having failed, the Achilles tendon and the long flexor muscle of the toes were lengthened by operation. Both signs and symptoms then improved. A compartment syndrome may develop after blunt trauma even in the absence of bony injury. If there are the appropriate clinical signs, intracompartmental pressure measurement is the procedure of choice to confirm the diagnosis quickly and thus avoid sequelae.