Acute isolated lateral leg compartment syndrome following a peroneus longus muscle tear

Acute compartment syndrome is a rare orthopedic emergency caused by orthopedic, vascular, iatrogenic, or soft tissue injury that elevates the pressure within a closed fascial space. Untreated acute compartment syndrome leads to ischemia of the muscles and nerves within the compartment with a resultant loss of motor and sensory function, death of skeletal muscle, and subsequent contracture and deformity. This article presents a case of compartment syndrome in a 33-year-old man following a peroneus longus muscle tear. The patient underwent emergent fasciotomy and decompression of the lateral compartment, and a hematoma located at the musculotendonous junction of the peroneus longus was evacuated. The patient was placed in a posterior splint with the ankle at 90 degrees and elevated. Postoperatively, the patient reported complete resolution of pain, numbness, and tingling. The patient underwent delayed skin closure on the second postoperative day and subsequently had an uneventful recovery. By 4 months postoperatively, he had resumed full activity. Knowledge of the signs and symptoms of compartment syndrome and a high index of suspicion is paramount as this injury can occur after a seemingly innocuous injury such as an ankle inversion injury.