Compartment Syndrome After Isolated Closed Transverse Fibular Shaft Fracture

In the lower extremity, compartment syndrome has been associated with fractures of the tibial plateau, shaft, and plafond. The patient was an 89-year-old male driver involved in a T-bone type motor vehicle accident. He sustained a closed transverse fibular shaft fracture and initially had fullness in his anterior/lateral compartments but no pain with passive and active range of motion of his ankle. Because of previous cardiac stenting, he was on dual anticoagulation therapy. Serial examination demonstrated tense compartments with notable pain during ankle range of motion. He was taken emergently to the operating room for four-compartment fasciotomies. On postoperative day 2, he returned to the operating room for débridement and underwent primary closure. The remainder of his hospital course was normal. Two-month follow-up did not demonstrate any compartment syndrome sequelae. In conclusion, patients on dual anticoagulation therapy are at a higher risk of developing compartment syndrome secondary to high-energy trauma, despite simple fracture patterns.