A 45-year-old man presenting with anterior compartment syndrome three weeks following conservative treatment of an Achilles tendon rupture

Abstract

Compartment syndrome complicating a ruptured Achilles tendon has previously been reported in a surgically treated patient. However – to our knowledge – this is the first report of compartment syndrome following conservative treatment. A 45-year-old man ruptured his Achilles tendon and elected to have treatment in an equinus cast. Three weeks later, he developed compartment syndrome and despite fasciotomy, required surgical debridement of his anterior compartment. Delay in both diagnosis and subsequent fasciotomy resulted in a poor outcome. Any suspicion of compartment syndrome mandates early compartmental pressure monitoring. The exact aetiology is uncertain but we speculate that the equinus position of his ankle combined with weight-bearing, was a major contributing factor.