Compartment syndrome in Duchenne muscular dystrophy

Boys with Duchenne muscular dystrophy typically lose the ability to walk independently between the ages of 10 and 12 yr, although this may be prolonged with steroid therapy. The loss of ambulation primarily reflects progressive weakness, although other factors may play a role. We describe a boy with Duchenne muscular dystrophy whose ability to walk was jeopardized at age 10 yr. He had contractures of both Achilles tendons and tight anterior compartments in both legs with discomfort over the anterior compartments bilaterally. Following tendon lengthening and fasciotomy of the anterior compartments his gait, level of functioning and discomfort greatly improved. He continues to ambulate for short distances without assistance at 18 years of age. Anterior compartment syndrome should be considered in boys with Duchenne dystrophy, especially if they have leg pain and are losing the ability to walk earlier than anticipated.