Exertional Compartment Syndrome Leading to Bilateral Foot Drop: A Case Report

Background: Although more commonly encountered with trauma, long-lasting exercise can cause a compartment syndrome. This is the first reported case of bilateral exertional compartment syndrome [ECS] that led to bilateral foot drop. Findings: A 20-year-old man presented with complaints of swelling and pain in both legs which starting after a long, strenuous exercise. Magnetic resonance imaging showed edema in the peroneus longus and brevis muscles. The electromyography examination demonstrated severe axonal degenerations on bilateral peroneus profundus nerves. The diagnosis of ECS of the both legs leading to bilateral foot drop was established. Decompressive fasciotomies was performed one month after the onset of complaints. Improvement after physical therapy and rehabilitation was not satisfactory. Conclusions: ECS can be overlooked as a diagnosis. Surgical decompression is the best choice of treatment. Late diagnosis and delayed surgery might lead to poor prognosis.