Description

ABSTRACT

Strauss M, Sass A, Wilson K, Miller S. Mixed Compartment Syndromes and Neuropathy Resolution

With Hyperbaric Oxygen. Undersea Hyperb Med. 2026 Second Quarter; 53(2):227-234.

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.

Keywords: exertional compartment syndrome; hyperoxygenation; lag phase; peroneal nerve palsy;

skeletal muscle-compartment syndrome