In brief: This case report presents an unusual complication in a distance runner who was treated for the shin splint syndrome. Following release of the deep posterior fascial compartment, he had mild erythema and swelling in the region of his incision. He could not bear full weight on his left leg because of pain. An arteriogram obtained approximately six months later showed an arteriovenous fistula, which was subsequently treated with resection and neurolysis of the saphenous nerve. The patient improved but did not reach his previous level of athletic performance. Recommendations for preventing this complication are outlined, and the use of the term shin splints is discussed.