Bilateral peroneal compartment syndrome after horse riding

      A healthy 20-year-old woman developed acute ischemia of the lateral compartment of both calves shortly after a 30-minute horse ride. On one side, she developed compartment syndrome with resultant complete myonecrosis of the compartment, whereas on the other side, there was spontaneous resolution. To our knowledge, this is the first report of bilateral lateral compartment ischemia after horse riding. Atraumatic compartment syndrome is a rare entity and is often missed at initial presentation. We discuss aspects of her management together with a review of the literature. Late fasciotomy and exploration may be beneficial in decompressing the deep peroneal nerve in peroneal compartment syndrome. Awareness of atraumatic compartment syndrome is important in any case of limb pain and swelling.
      To read this article in full you will need to make a payment
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Tiwari A.
        • Haq A.I.
        • Myint F.
        • Hamilton G.
        Acute compartment syndromes.
        Br J Surg. 2002; 89 ([Review]): 397-412
        • Whitesides T.E.
        • Heckman M.M.
        Acute compartment syndrome: update on diagnosis and treatment.
        J Am Acad Orthop Surg. 1996; 4: 209-218
        • Kuklo T.R.
        • Tis J.E.
        • Moores L.K.
        • Schaefer R.S.
        Fatal rhabdomyolysis with bilateral gluteal, thigh, and leg compartment syndrome after the Army Physical Fitness Test. A case report.
        Am J Sports Med. 2000; 28: 112-116
        • Cara J.A.
        • Narvaez A.
        • Bertrand M.L.
        • Guerado E.
        Acute atraumatic compartment syndrome in the leg.
        Int Orthop. 1999; 23: 61-62
        • Vanneste D.R.
        • Janzing H.M.
        • Broos P.L.O.
        The acute atraumatic compartment syndrome, a rare and therefore sometimes unrecognised entity.
        Acta Chir Belg. 2003; 103: 355-357
        • Blasier D.
        • Barry R.
        • Weaver T.
        Forced march-induced peroneal compartment syndrome. A report of two cases.
        Clin Orthop Relat Res. 1992; 284: 189-192
        • Ebenezer E.
        • Dust W.
        Missed acute isolated peroneal compartment syndrome.
        CJEM. 2002; 4: 355-358
        • Lipscomb A.B.
        • Ibrahim A.A.
        Acute peroneal compartment syndrome in a well conditioned athlete: report of a case.
        Am J Sports Med. 1977; 5: 154-157
        • McKee M.D.
        • Jupiter J.B.
        Acute exercised-induced bilateral anterolateral leg compartment syndrome in a healthy young man.
        Am J Ortho. 1995; 24: 862-864
        • Reneman R.S.
        The anterior and the lateral compartment syndrome of the leg due to intensive use of muscles.
        Clin Orthop. 1975; 113: 69-80
        • Adam F.
        • Roren A.
        • Chauvin M.
        Uncommon aetiology of peroneal compartment syndrome.
        Ann Fr Anesth Reanim. 2005; 24 ([French]): 432-434
        • Nicholson P.
        • Devitt A.
        • Stevens M.
        • Mahalingum K.
        Acute exertional peroneal compartment syndrome following prolonged horse riding.
        Injury. 1998; 29: 643-644
        • Gershuni D.H.
        • Yaru N.C.
        • Hargens A.R.
        • Leiber R.L.
        • O'Hara R.C.
        • Akeson W.H.
        Ankle and knee position as a factor modifying intracompartmental pressure in the human leg.
        J Bone Joint Surg Am. 1984; 64: 1415-1420
        • Jacobs D.
        • Azagra J.S.
        • Delauwer M.
        • Bain H.
        • Vanderheyden J.E.
        Unusual complication after pelvic surgery: unilateral lower limb crush syndrome and bilateral common peroneal nerve paralysis.
        Acta Anaesthesiol Belg. 1992; 43: 139-143
        • Adkison D.P.
        • Bosse M.J.
        • Gaccione D.R.
        • Gabriel K.R.
        Anatomical variations in the course of the superficial peroneal nerve.
        J Bone Joint Surg Am. 1991; 73: 112-114