Mixed Compartment Syndromes and Neuropathy Resolution With Hyperbaric Oxygen

Area of Science:

• Sports Medicine
• Neurology
• Orthopedics

Background:

• Skeletal muscle compartment syndrome (SMCS) and exertional compartment syndrome (ECS) are distinct conditions.
• This case report details a unique instance where both SMCS and ECS arose from identical triggering events.
• Residual neuropathy following SMCS is a known complication.

Purpose of the Study:

• To report a case of concurrent SMCS and ECS.
• To investigate the resolution of residual neuropathy with hyperbaric oxygen (HBO₂) therapy.
• To highlight the potential role of HBO₂ in managing SMCS-related nerve deficits.

Main Methods:

• Retrospective analysis of a patient presenting with severe leg pain after strenuous activity.
• Documentation of symptoms consistent with both SMCS and ECS.
• Administration of a single HBO₂ treatment for residual peroneal nerve dysfunction.
• Subsequent evaluation for ECS and bilateral leg fasciotomies.

Main Results:

• The patient experienced severe leg pain after intense ballet and gymnastics sessions, indicative of both SMCS and ECS.
• A steppage gait developed the following day, signifying peroneal nerve palsy.
• A single HBO₂ treatment successfully restored peroneal nerve function.
• The patient underwent fasciotomies for ECS and returned to athletic activities symptom-free.

Conclusions:

• Concurrent SMCS and ECS can result from the same precipitating activity.
• Hyperbaric oxygen therapy demonstrated efficacy in resolving peroneal nerve palsy secondary to SMCS.
• This case supports the use of HBO₂ as a therapeutic option for SMCS-induced neuropathy.