McKinney Brandon, Gaunder Christopher, Schumer Ross
Department of Orthopedic Surgery, San Antonio Military Medical Center (SAMMC), San Antonio, TX, USA.
Am J Case Rep. 2018 Feb 8;19:145-149. doi: 10.12659/ajcr.907304.
BACKGROUND Acute exertional compartment syndrome (AECS) is a rare cause of leg pain often associated with a delay in diagnosis and potentially leading to irreversible muscle and nerve damage. CASE REPORT We present the case of a previously healthy, high-level athlete who presented with the acute onset of unilateral anterior leg pain and foot drop the day after a strenuous workout. He was diagnosed with compartment syndrome and rhabdomyolysis. His management included emergent fluid resuscitation, fasciotomies, debridement of necrotic muscle from his anterior compartment, and delayed primary closure. After six months of intensive outpatient physical therapy, including the use of blood flow restriction treatments, the patient returned to sports and received a NCAA Division I Football scholarship. CONCLUSIONS We describe the details of this patient's case and review the literature related to acute exertional compartment syndrome. The occurrence of acute compartment syndrome in the absence of trauma or fracture, though rare, can have devastating consequences following delays in treatment. AECS requires prompt diagnosis and surgical intervention to prevent these consequences. Diagnosis of atraumatic cases can be difficult, which is why awareness is equally as important as history and physical examination. While diagnosis is primarily clinical, it can be supported with direct intra-compartmental pressure measurements and maintaining a high index of suspicion in acute presentations of exertional limb pain.
背景 急性运动性骨筋膜室综合征（AECS）是导致腿痛的罕见原因，常与诊断延迟相关，并可能导致不可逆的肌肉和神经损伤。
病例报告 我们报告一例既往健康的高水平运动员病例，该患者在剧烈锻炼一天后出现单侧小腿前部急性疼痛和足下垂。他被诊断为骨筋膜室综合征和横纹肌溶解症。其治疗包括紧急液体复苏、筋膜切开术、清创坏死的小腿前侧肌肉以及延迟一期缝合。经过六个月的强化门诊物理治疗，包括使用血流限制治疗，患者恢复运动，并获得了美国大学体育总会（NCAA）一级橄榄球奖学金。
结论 我们描述了该患者病例的详细情况，并回顾了与急性运动性骨筋膜室综合征相关的文献。在无创伤或骨折的情况下发生急性骨筋膜室综合征虽然罕见，但治疗延迟后可能会产生毁灭性后果。AECS需要及时诊断和手术干预以防止这些后果。非创伤性病例的诊断可能困难，这就是为什么意识与病史和体格检查同样重要。虽然诊断主要基于临床，但可通过直接测量骨筋膜室内压力来辅助诊断，并在运动性肢体疼痛的急性表现中保持高度怀疑指数。
