Strauss M, Sass A, Wilson K, Miller S, et al.
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc. Date of publication 2026 Apr 1;volume 53(2):227-234.
1. Undersea Hyperb Med. 2026 Second Quarter;53(2):227-234.
Mixed Compartment Syndromes and Neuropathy Resolution With Hyperbaric Oxygen.
Strauss M(1), Sass A(2), Wilson K(3), Miller S(1).
Author information:
(1)MemorialCare Long Beach Medical Center, Long Beach, California.
(2)University of California Los Angeles, Los Angeles, California.
(3)University of California San Diego School of Medicine, San Diego, California.
INTRODUCTION: Skeletal muscle compartment syndrome (SMCS) and exertional
compartment syndrome (ECS) are two distinct conditions. This case report
describes a situation in which both conditions resulted from the same triggering
events. The importance of this case lies in the fact that the residual
neuropathy associated with the SMCS resolved after a single hyperbaric oxygen
(HBO₂) treatment.
CASE REPORT: This report was generated from a retrospective analysis of the
patient's combined compartment syndromes, SMCS and ECS, residual functional
deficit, and resolution of the latter with HBO₂ treatment. Severe leg pain
developed after two strenuous back-to-back ballet and gymnastics sessions.
Similar leg pains of lesser severity had occurred previously but always resolved
after the activity was stopped. During this episode, the pain subsided; however,
the next day, the patient began to walk with a steppage gait. The athlete
received HBO₂ treatment, which restored her peroneal nerve function.
Subsequently, the patient underwent an ECS evaluation, bilateral leg
fasciotomies, and returned to athletic activities without symptoms.
DISCUSSION: A residual nerve palsy can result from an SMCS. This symptom,
combined with the rapid resolution of pain symptoms consistent with an ECS,
suggests that both problems resulted from the same cause. The delayed onset of
the drop foot was attributed to the self-perpetuating cycle of ischemia and
edema associated with the lag phase of the SMCS. The resolution of the peroneal
nerve palsy with HBO₂ treatment adds additional validation for the roles of HBO₂
in SMCS.
Copyright© Undersea and Hyperbaric Medical Society.
PMID: 42365942 [Indexed for MEDLINE]
Conflict of interest statement: The authors of this paper declare no conflicts
of interest exist with this submission.
