Acute Compartment Syndrome Following Repeated Calf Kicks in an Elite-Level Kickboxing Athlete: A Case Report of a Rare Non-Fracture-Related Complication.

Background

Acute compartment syndrome (ACS) is a limb-threatening surgical emergency most commonly associated with fractures or high-energy trauma. Non-fracture-related ACS in athletes is uncommon and may lead to delayed diagnosis. Repetitive blunt trauma during combat sports has rarely been described as a potential mechanism. Case

Methods

The case concerns a 21-year-old elite-level kickboxing athlete who developed acute compartment syndrome of the left lower leg following repeated calf kicks sustained during sparring. The patient presented with rapidly progressive calf pain, swelling, compartment firmness, paresthesias and weight bearing difficulties. CT angiography demonstrated diffuse edema of the posterior compartments associated with a large intramuscular soleus hematoma without active arterial bleeding.

Results

In view of the severity of the symptoms and the characteristic clinical presentation, an emergency fasciotomy was performed in operating room. Progressive closure was achieved using the vessel loop shoelace technique, allowing gradual tension-free closure. Wound healing progressed without infection, and physiotherapy was introduced with joint mobilization. The patient achieved full functional recovery after 6 months.

Conclusions

This case illustrates an atypical etiology of ACS-repetitive targeted calf strikes-and underscores the importance of early recognition even in the absence of fracture or major trauma. Clinical vigilance remains paramount, and prompt surgical intervention is critical to prevent irreversible muscle and nerve damage. Awareness of such mechanisms is particularly relevant for clinicians managing athletes in combat sports. To our knowledge, this is the first documented case of ACS secondary to repeated calf kicks in kickboxing.