Exercise-Induced Compartment Syndrome in the Flexor-Pronator Muscle Group

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Abstract
Compartment syndrome is caused by an increase in intracompartmental pressure above the capillary level, preventing capillary flow. The acute onset of symptoms occurs after events such as fracture, soft tissue trauma, and revascularization and usually necessitates prompt fasciotomy to avoid loss of function or even necrosis of the enclosed muscle. Compartment syndromes in athletes are of a recurrent nature and are usually referred to as chronic. Nonoperative treatment is often successful. Although compartment syndromes can occur in several anatomic regions, the most commonly seen in athletes involve the leg. Chronic compartment syndromes of the upper extremity are rare, and only a few cases have been reported in the literature. The intracompartmental pressures causing chronic symptoms in these cases ranged between 22 mm Hg at rest and 40 mm Hg after 30 minutes of exercise. Under maximal contraction, a pressure of 58 mm Hg has been recorded. The object of this paper is to report a case of a tennis player where much higher flexor-pronator muscle intracompartmental pressures than those noted above were recorded. We compared the intracompartmental pressure data of this patient with intracompartmental pressures measured in six symptom-free volunteers.