Pediatric acute leg compartment syndrome after peroneus longus rupture: a case series

Area of Science:

• Orthopedic Surgery
• Pediatric Sports Medicine
• Trauma Care

Background:

• Acute compartment syndrome (ACS) is a surgical emergency typically associated with fractures.
• Pediatric ACS, especially in the absence of fracture, is rare and often underdiagnosed.
• Sports-related injuries in adolescents are a common cause of musculoskeletal trauma.

Observation:

• Three male pediatric patients presented with acute lateral compartment syndrome following minor trauma during football.
• All patients sustained intramuscular proximal avulsion ruptures of the peroneus longus muscle.
• Two patients were able to resume athletic activity post-injury.

Findings:

• Non-fracture acute lateral compartment syndrome can result from seemingly minor trauma in adolescent males.
• Intramuscular proximal avulsion ruptures of the peroneus longus muscle were identified in all cases.
• Full neurologic recovery was documented in most patients at final follow-up.

Implications:

• Clinicians should maintain a high index of suspicion for compartment syndrome in adolescent athletes, even without obvious fractures.
• Early diagnosis and surgical decompression are vital to prevent long-term complications.
• This presentation highlights a specific injury pattern in pediatric football players that warrants prompt recognition.