Robles Emilio L, Pache Killian M, Gluck Joshua S
Department of Orthopaedic Surgery, Community Memorial Hospital, Ventura, CA, USA.
Department of Neuroscience, University of Washington, Seattle, WA, USA.
J Surg Case Rep. 2022 Nov 3;2022(11):rjac502. doi: 10.1093/jscr/rjac502. eCollection 2022 Nov.
Delayed diagnosis of acute compartment syndrome (ACS) can be catastrophic. Reporting abnormal presentations to facilitate timely diagnosis and treatment is vital. We present a case of ACS in the deep posterior compartment of the leg with an unusual presentation and cause. The patient presented to the emergency department complaining of numbness on the plantar aspect of his left foot, and described a history of cocaine use, increased exercise and creatine supplementation. The patient was diagnosed with acute deep posterior compartment syndrome of the left leg and underwent a lower extremity fasciotomy. There are case reports demonstrating that strenuous activity, drug use and creatine supplementation cause increased compartment pressures and ACS. Rare in the literature is a case where these activities occur concurrently with the abnormal presentation of symptoms seen in this case. We hope this case brings awareness of atraumatic risk factors and uncommon presentations to the medical community.
急性骨筋膜室综合征（ACS）的延迟诊断可能是灾难性的。报告异常表现以促进及时诊断和治疗至关重要。我们报告一例发生在小腿深后骨筋膜室的ACS病例，其表现和病因不寻常。该患者因左足底麻木就诊于急诊科，自述有使用可卡因、增加运动和补充肌酸的病史。患者被诊断为左下肢急性深后骨筋膜室综合征，并接受了下肢筋膜切开术。有病例报告表明，剧烈活动、药物使用和补充肌酸会导致骨筋膜室内压力升高和ACS。文献中很少有这些活动与本病例中出现的异常症状同时发生的情况。我们希望这个病例能让医学界认识到非创伤性危险因素和不常见的表现。
