Case of Foot Compartment Syndrome in a Marathon Runner

In this case report, orthopedic surgeons from Switzerland present a patient who developed an unusual type of compartment syndrome. Compartment syndrome is an increased amount of pressure from swelling inside a small space. Usually this occurs in an area where a group of muscles are contained by fascia (connective tissue lining).

The most common site of compartment syndrome is the lower leg. It's a potentially dangerous condition. Blood supply to the area is cut off. Without treatment right away, nerve damage and death of the muscles can occur.

Most of the time, compartment syndrome is caused by trauma to the soft tissue or bone. Repetitive microtrauma from overuse or chronic activity is a typical risk factor. But in the case of this 40-year old marathon runner (male), exertion was the main cause of the condition.

Symptoms of severe pain, swelling, and pale looking skin were reduced dramatically with surgery. Surgery was done to decompress the medial compartment of the foot. The surgeons reported opening the foot and finding a swollen, blue-color abductor hallucis muscle.

MRIs taken before the procedure confirmed the diagnosis and helped show the surgeon exactly where the problem was located. This information helped avoid unnecessary cutting of the fascia.

Recovery went well for this patient. The stitches were removed two weeks after the surgery. He was up and putting partial weight on that leg several days post-op. By the end of two weeks, he was full weight-bearing. At six weeks, he was back to jogging without any pain or swelling. A full recovery was made without problems or complications.

The authors published this case report to highlight the fact that compartment syndrome can occur as a result of exertion. Although it's uncommon, when it occurs, immediate diagnosis and treatment are required for a successful result.