Exercise induced compartment syndrome of the pectoralis major/deltoid in a professional tree climber

A 35-year-old male sustained a lateral malleolar fracture while playing football. The fracture was treated by open reduction and internal fixation with a tourniquet. The next day, the patient returned with pain and swelling of the ankle and was admitted again to the hospital with a suspected diagnosis of cellulitis. Ten hours later, the patient developed the symptoms of anterior compartment syndrome. Emergency open fasciotomy of the anterior compartment was performed. The retrospective analysis of the patient’s history was suggestive of a predisposition to an exercise-induced compartment syndrome. We think that exertional increase of the compartmental pressure before the injury and the tourniquet used during surgery contributed together to the development of compartment syndrome. Physicians should be vigilant in identifying the features of compartment syndrome when managing patients injured during a sporting activity. (J Am Podiatr Med Assoc 99(5): 438–442, 2009)

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Exercise-Induced Paraspinal Muscle Rhabdomyolysis with Seconary Compartment Syndrome: A Case Report

Journal of the Korean Society of Radiology ◽

10.3348/jksr.2019.80.6.1229 ◽

2019 ◽

Vol 80 (6) ◽

pp. 1229

Author(s):

Soong Moon Cho ◽

Ghi Jai Lee ◽

Yong Jun Jin ◽

Ki Hwan Kim ◽

Kyoung Eun Lee ◽

...

Keyword(s):

Case Report ◽

Compartment Syndrome ◽

Paraspinal Muscle ◽

Exercise Induced

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Chronic exertional compartment syndrome: diagnosis, investigation, management and return to training

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-104-124 ◽

2018 ◽

Vol 104 (2) ◽

pp. 124-128

Author(s):

R L Thomas ◽

R Hemingway ◽

A Keenan ◽

A Wood

Keyword(s):

Compartment Syndrome ◽

Lower Limbs ◽

Leg Pain ◽

Military Recruit ◽

Chronic Exertional Compartment Syndrome ◽

Military Recruits ◽

Exertional Compartment Syndrome ◽

Poor Outcomes ◽

Exercise Induced ◽

The Military

AbstractExercise-induced leg pain is a frequent presenting complaint in military recruits. This has several causes, including chronic exertional compartment syndrome (CECS). The pathophysiology of CECS is debated, but it involves pressure increases in particular compartments and reduced compliance in the epimyseal fascia. Its morbidity and poor outcomes with conservative management lead to extended rehabilitation times, and ultimately to a loss of recruits from training. It has been described in various compartments of the upper and lower limbs, but is most frequently encountered in the leg. It is a condition often encountered in the military recruit, and within this demographic is less common than other causes of exertional lower leg pain. However, its debilitating nature and complicated investigative pathway can cause difficulties, and have notable occupational consequences. This article aims to review the evidence surrounding its diagnosis, treatment, prognosis and the implications for the military patient.

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Compartment Syndrome of the Flexor Compartment of the Arm Secondary to Pectoralis Major Tendon Rupture

Case Reports in Orthopedics ◽

10.1155/2018/9042820 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

M. A. Tranovich ◽

J. B. Stirton ◽

J. C. Maier ◽

M. B. Tanios ◽

J. E. Lea ◽

...

Keyword(s):

Compartment Syndrome ◽

Tendon Rupture ◽

Pectoralis Major ◽

Weight Lifting ◽

Rare Entity ◽

Anterior Compartment ◽

Muscle Rupture ◽

Missed Compartment Syndrome ◽

High Level

Case. Compartment syndrome following muscle rupture is a rare entity with few mentions in the literature. We present a case of pectoralis major rupture in a 38-year-old male that evolved into compartment syndrome of the anterior compartment of the arm. Rupture of the pectoralis is uncommon and most often occurs during weight lifting. Compartment syndrome secondary to this injury is extremely uncommon, with only one reported case in the pectoralis major itself and several cases of biceps compartment syndrome. Due to the potentially devastating consequences of a missed compartment syndrome, it is imperative that physicians maintain a high level of suspicion in patients with these unusual injuries presenting with severe swelling and pain.

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Bilateral Exercise-Induced Compartment Syndrome of the Thigh and Leg Associated with Massive Heterotopic Ossification: A Case Report

JBJS Case Connector ◽

10.2106/jbjs.e.01441 ◽

2006 ◽

Vol os-88 (10) ◽

pp. 2265-2269 ◽

Cited By ~ 4

Author(s):

J. R. Lynch ◽

M. V. Jenkins ◽

D. G. Smith ◽

C. Bellabarba

Keyword(s):

Case Report ◽

Heterotopic Ossification ◽

Compartment Syndrome ◽

Exercise Induced

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An exercise-induced compartment syndrome of the dorsal forearm—A case report

The Journal Of Hand Surgery ◽

10.1016/s0363-5023(84)80205-1 ◽

1984 ◽

Vol 9 (1) ◽

pp. 142-143 ◽

Cited By ~ 31

Author(s):

Joseph E. Imbriglia ◽

David M. Boland

Keyword(s):

Case Report ◽

Compartment Syndrome ◽

Exercise Induced

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Minimally Invasive Fasciotomy for Chronic Exercise-Induced Compartment Syndrome

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000321 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0003

Author(s):

Manuel Pellegrini ◽

Giovanni Carcuro ◽

Gerardo Muñoz ◽

Marcelo Somarriva ◽

Natalio Cuchacovic ◽

...

Keyword(s):

Minimally Invasive ◽

Compartment Syndrome ◽

Functional Outcomes ◽

Delayed Diagnosis ◽

Leg Pain ◽

Return To Sports ◽

Chronic Exercise ◽

Functional Scores ◽

Exercise Induced

Category: Sports Introduction/Purpose: Chronic? exercise-induced compartment syndrome (CEICS) is a commonly misdiagnosed source of pain. Although CEICS is seen infrequently in the general population, its incidence in high-performance athletes is estimated to be 0.49 per 1000 per year. Delayed diagnosis should be avoided, as irreversible sequelae can result, often causing sports retirement. We present our experience in diagnosis and treatment of CEICS. Methods: After IRB approval, we conducted a retrospective patient chart review. Patients were included if they were older than 18 years, experienced leg pain after 30 minutes of intense exercise, had a normal-appearing leg MRI, and failed conservative therapy for a minimum of six-months. Patients were excluded if they were diabetic or neuropathic. Significant increments in post-exercise compartment pressure were demonstrated in all patients using Whitesides’ measurement technique. All patients were operated on with minimally invasive fasciotomy and followed for a minimum of 6 months. Complications, functional outcomes (FAAM, FAOS & LEFS), and return-to-sports time were documented. Results: Seven male patients met inclusion criteria, with a mean age of 29 years (20-45). Four patients presented pain in the left leg, and three patients were symptomatic in both the right and left legs. All patients had an incremented pressure differential in the anterior compartment, while two exhibited a concomitant pressure increment in the lateral compartment. Postoperatively there was a significant subjective improvement in pain, functionality, and sports performance. High functional scores (FAAM x=92.4, FAOS x=90.3, and LEFS x=72) were documented at 6 months follow-up. Patients returned to sports at an average of 15 weeks and resumed a pre-surgery sports level at an average of 24 weeks. No complications were observed. Conclusion: Our results suggest that CEICS can be approached safely through a minimally invasive fasciotomy, with satisfactory functional outcomes and return to sports in the short term follow-up.

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