Recurrent Metachronous Acute Compartment Syndrome in the Legs of a Child

BACKGROUND: Compartment syndromes in children are rare, rarer still is the occurrence of metachronous compartment syndrome. OBJECTIVE: To report an unusual and rare presentation of metachronous acute compartment syndrome. METHODS: A seven-year-old boy presented with four separate episodes of acute compartment syndrome of the legs within three years. The recurrent nature of the illness prompted detail review of the records of the child. RESULTS: There was involvement of each leg twice between the ages of three and seven years following trivial trauma. At first presentation of each leg, fasciotomy was carried out in one or two compartments. There was no recurrence after fasciotomy of the four compartments during the second presentation of each leg. CONCLUSIONS: This case shows that a child could develop metachronous compartment syndrome in the legs following trivial injury and high index of suspicion is needed to recognize it. It also illustrates the importance of carrying out fasciotomy of all the four compartments to avoid recurrence of the pathology.