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He could have a second bout of compartment syndrome. Having it once does increase the chances of getting it again. But it doesn't guarantee the problem will come back. Some of it depends on the original cause of the problem and the presence of any risk factors.
Trauma to the soft tissues or bone is the usual way compartment syndrome gets started. Only a handful of cases have been reported without a specific traumatic event. Running a marathon could be considered a traumatic event in itself. But it's possible that your grandfather suffered a fall, twisted ankle, or other injury to his foot.
In the cases that have been reported, the patients recovered well from exertional compartment syndrome. One 40-year old man was able to resume running and training for marathons within six months' time.
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