Unusual development of acute exertional compartment syndrome due to delayed diagnosis. A case report

Our report describes the case of a 20 year old man who developed an acute exertional anterior tibial compartment syndrome after playing soccer for five minutes. No trauma was reported. Correct diagnosis was delayed for 18 hours, because pain was misinterpreted as resulting from acute muscular tetanic spasm induced by hyperventilation. Fasciotomy was contributed. After one year, the patient complained of early fatigue. Electromyographically the reinnervation had not yet been completed. This case illustrates the necessity for careful observation of non-trauma related acute tibial anterior pain appearing even at the beginning of strenuous exercise. It is important to recognize the possibility of a very acute onset of exertional compartment syndrome that does not subside with rest. Only early diagnosis and fasciotomy can prevent severe complications of an acute exertional compartment syndrome.