Cause:Genetic predisposition? or trauma

Pathophys:Anterior tibial compartment claudication from congenitally or traumatically edematous small compartment, which prevents normal vascular engorgement of exercising muscles

Males in their 20s; trauma to anterior legs

Sx:Anterior shin pain, esp if walking on heels, usually bilateral. Relief by walking on toes or resting; can run ok

Si:BP can be auscultated after exercise over dorsalis pedis pulse without BP cuff. Muscle hernias through anterior fascial compartment

Ischemic necrosis of anterior tibial muscles possible even without pain

r/o SHIN SPLINTS caused by periostitis and microfractures of bone; bone scan is positive; more frequent in osteoporotic athletes (Ann IM 1990;113:754); rx by discontinuation of running trauma

Acute anterior compartment syndrome after trauma, w acute swelling, which if not relieved surgically can lead to ischemic death of anterior compartment muscles

Lab:

NIL:Measurement of compartment pressures during exercise

Rx:

Cross friction massage; fasciotomies of anterior tibial compartments rarely indicated but fails only if don’t expose all compartments