Chronic compartment syndrome secondary to venous hypertension: fasciectomy for symptom relief

Chronic compartment syndrome (CCS) from venous hypertension following lower leg deep venous thrombosis or severe venous insufficiency is rare and often difficult to diagnose. Although ileocaval stenting and thrombolysis have improved claudication symptoms related to outflow venous disease, chronic calf claudication from distal vein thrombosis and venous insufficiency have historically been managed with rest, compression, and elevation. Often, conservative options give inadequate symptom relief and active individuals are rarely compliant. We report the presentation, workup, and treatment with fasciectomy for lower leg CCS secondary to venous hypertension. Fasciotomy and fasciectomy have been used for atypical claudication secondary to classic overuse CCS with symptom relief for many individuals. This case illustrates the recognition of claudication induced by CCS secondary to venous insufficiency and an approach to treatment with fasciectomy with a promising outcome.