[Acute compartment syndrome following the International Four Days Marches Nijmegen]

Acute compartment syndrome of the anterior and lateral compartment of the lower right leg was diagnosed in a 47-year-old woman after she had taken part in the 'International Four Days Marches Nijmegen', the Netherlands. Initially a fasciotomy was carried out, but later resection of the entire peroneus musculature was also required as it had become necrotic. Acute compartment syndrome of the lower leg is a potentially limb threatening condition, requiring emergency surgical treatment. Known causes are high-energy impact, and reperfusion after vascular procedures, but it can also be caused by prolonged stress such as during sustained walking. Although it is rare, the possibility of acute compartment syndrome of the lower leg should be borne in mind when making a diagnosis in patients presenting with pain after prolonged repetitive stress.