I am a college football player with hopes for a chance at some national league play. After getting kicked in the leg during a scrimmage, my leg blew up like a balloon. I had surgery to release the soft tissues and drain the area. The follow-up X-ray showed a bridge of bone formed in my lower leg that wasn't there before. Does this mean I'm out of the game?

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It sounds like you may have started out with a condition called acute compartment syndrome (ACS). Injury leading to painful swelling inside the lower leg puts pressure on the nerves and blood vessels. Without surgical release called a fasciotomy there can be serious consequences.

Acute compartment syndrome is not uncommon. What is more rare is the formation of a bridge of bone between the two lower leg bones. This extra piece of bone is called a synostosis.

The synostosis connects the tibia to the fibula, preventing full, normal motion between the bones. This motion is needed for pivoting, twisting, and cutting required in football. The excessive load causes tiny fractures called microfracture to form inside the synostosis.

Repetitive forces or trauma (like getting kicked in the leg) can trigger another episode of ACS. Reports of other athletes with this problem suggest that the problem reoccurs in about a fourth of the patients. Even if this happens a second time, with the right treatment and rehab, the player can get back into the game.

Bryan Hanypsiak, MD, et al. Recurrent Compartment Syndrome After Fracture of a Tibiofibular Synostosis in a National Football League Player. In American Journal of Sports Medicine. Vol. 35. No. 1. Pp. 127-130.



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