Acute compartment syndrome of the leg caused by cocaine use, creatine supplementation and vigorous exercise
Open accessAbstract
Delayed diagnosis of acute compartment syndrome (ACS) can be catastrophic. Reporting abnormal presentations to facilitate timely diagnosis and treatment is vital. We present a case of ACS in the deep posterior compartment of the leg with an unusual presentation and cause. The patient presented to the emergency department complaining of numbness on the plantar aspect of his left foot, and described a history of cocaine use, increased exercise and creatine supplementation. The patient was diagnosed with acute deep posterior compartment syndrome of the left leg and underwent a lower extremity fasciotomy. There are case reports demonstrating that strenuous activity, drug use and creatine supplementation cause increased compartment pressures and ACS. Rare in the literature is a case where these activities occur concurrently with the abnormal presentation of symptoms seen in this case. We hope this case brings awareness of atraumatic risk factors and uncommon presentations to the medical community.
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A few case study reports appeared in the literature suggesting adverse events despite other mitigating factors unrelated to creatine supplementation, which subsequently have been debunked.
“A few case study reports also appeared in the literature suggesting adverse events despite other mitigating factors unrelated to creatine supplementation [52–54] which subsequently have been debunked [15,55,56].”
From Safety of creatine supplementation: analysis of the prevalence of reported side effects in clinical trials and adverse event reports (2025) · cites this paper as [54]
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Research works printed but not linked: 14
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Cited by
Sorted by citations
Kreider, R. B., Gonzalez, D. E., Hines, K., Gil, A., & Bonilla, D. A. (2025) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2025.2488937 · Cited by 29 · see citing works
- Authors
- Robles, E. L., Pache, K. M., & Gluck, J. S.
- Affiliations
- Department of Orthopaedic Surgery, Community Memorial Hospital , Ventura, CA , USA
- University of Washington (US)
- Corresponding author
- Robles, Emilio L
- Venue
- Journal of Surgical Case Reports
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-11-01
- Volume
- 2022
- Issue
- 11
- Pages
- rjac502-rjac502
- ISSN
- 2042-8812 (ISSN-L)
- PMC
- PMC9907039
- OpenAlex
- W4319783668
- Cited by
- 4
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1
- FWCI
- 0.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Surgical Case Reports (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Muscle and Compartmental Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
- Health Sciences › Medicine › Surgery › Case Reports on Hematomas
- Keywords
- acute compartment syndrome, legs, cocaine use, creatine supplementation, high-intensity exercise, fasciotomy, compartment pressure, atypical presentation, foot numbness
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