Isolated lateral leg compartment syndrome following an ankle sprain

Description

A 25-year-old man came to the emergency room after an inversion ankle sprain during a soccer game with friends. He was unable to play after the injury but was able to walk. He complained about a lateral ankle pain that was rapidly increasing in intensity and spreading to the leg. At the first physical examination, we found a lateral malleolus oedema with normal and almost painless dorsi and plantar ankle flexion, but with severe pain with foot inversion and important weakness on foot eversion. He was initially managed with pain medication and leg elevation while waiting for the imagological study. The plain X-ray and ankle CT showed no significant bone or soft tissue lesion.

At second evaluation, approximately 1 hour later (4 hours after initial trauma), the patient pain was worst and he had an important oedema and tenderness of the lateral leg compartment (figure 1). He...

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