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Two minimal incision fasciotomy for chronic exertional compartment syndrome of the lower leg

  • Sports Medicine
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Chronic exertional compartment syndrome (CECS) of the leg is a pathological condition often related to overuse in subject who engage repetitive physical activities. Fascial release is the mainstay of surgical management. The purpose of this study was to evaluate the results obtained with a double incision decompressive fasciotomy. Eighteen consecutive athletes with a diagnosis of anterior and/or lateral CECS of the leg were operated on with a minimal double incision fascial release after a mean period of 4 months after onset of symptoms. In 11 cases (61%) CECS was bilateral. Surgery was performed without tourniquet and active mobilization was starting immediately. Sports activities were resumed gradually at a mean period of 25 days. The athletes were followed until 2 years. All resumed pre-injury level sports activity. Two patients (18%) of the 11 who underwent to bilateral fasciotomy referred a sensation of leg weakness for an average period of 3 months. The surgical technique presented in this paper seems to be a good mean to treat anterior and lateral leg CECS. The use of tourniquet is deconselled to obtain an accurate intraoperative haemostasis so reducing the risk of post-operative haematoma.

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References

  1. Allen MJ, Barnes MR (1986) Exercise pain in the lower leg. Chronic compartment syndrome and medial tibial syndrome. J Bone Joint Surg Br 68(5):818–823

    CAS  PubMed  Google Scholar 

  2. Balduini FC, Shenton DW, O’Connor KH, Heppenstall RB (1993) Chronic exertional compartment syndrome: correlation of compartment pressure and muscle ischemia utilizing 31P-NMR spectroscopy. Clin Sports Med 12(1):151–165

    CAS  PubMed  Google Scholar 

  3. Bell S (1986) Repeat compartment decompression with partial fasciectomy. J Bone Joint Surg Br 68(5):815–817

    CAS  PubMed  Google Scholar 

  4. Black KP, Schultz TK, Cheung NL (1990) Compartment syndromes in athletes. Clin Sports Med 9(2):471–487

    CAS  PubMed  Google Scholar 

  5. Blackmann PG (2000) A review of chronic exertional compartment syndrome in the lower leg. Med Sci Sports Exerc 32 (3 Suppl):S4–S10

    Article  PubMed  Google Scholar 

  6. Cook S, Bruce G (2002) Fasciotomy for chronic compartment syndrome in the lower limb. ANZ J Surg 72(10):720–723

    Article  PubMed  Google Scholar 

  7. Detmer DE, Sharpe K, Sufit RL, Girdley FM (1985) Chronic compartment syndrome: diagnosis, management, and outcomes. Am J Sports Med 13(3):162–170

    CAS  PubMed  Google Scholar 

  8. Howard JL, Mohtadi NG, Wiley JP (2000) Evaluation of outcomes in patients following surgical treatment of chronic exertional compartment syndrome in the leg. Clin J Sport Med 10(3):176–184

    Article  CAS  PubMed  Google Scholar 

  9. Hutchinson M, Ireland ML (1994) Common compartment syndromes in athletes. Treat Rehabilit Sports Med 17(3):200–208

    CAS  Google Scholar 

  10. Hutchinson MR, Bederka B, Kopplin M (2003) Anatomic structures at risk during minimal-incision endoscopically assisted fascial compartment releases in the leg. 14. Am J Sports Med 31(5):764–769

    PubMed  Google Scholar 

  11. Leversedge F, Casey PJ, Seiler JG 3rd, Xerogeanes JW (2002) Endoscopically assisted fasciotomy: description of technique and in vitro assessment of lower-leg compartment decompression. Am J Sports Med 30(2):272–278

    PubMed  Google Scholar 

  12. Martens MA, Backaert M, Varmaut G, Mulier JC. (1984) Chronic leg pain in athletes due to a recurrent compartment syndrome. Am J Sports Med 12(2):148–51

    CAS  PubMed  Google Scholar 

  13. Ota Y, Senda M, Hashizume H, Inoue H (1999) Chronic compartment syndrome of the lower leg: a new diagnostic method using near-infrared spectroscopy and a new technique of endoscopic fasciotomy. Arthroscopy 15(4):439–43

    CAS  PubMed  Google Scholar 

  14. Puranen J, Alavaikko A (1981) Intracompartmental pressure increase on exertion in patients with chronic compartment syndrome in the leg. J Bone Joint Surg Am 63(8):1304–1309

    CAS  PubMed  Google Scholar 

  15. Qvarfordt P, Christenson JT, Eklof B, Ohlin P, Saltin B (1983) Intramuscular pressure, muscle blood flow, and skeletal muscle metabolism in chronic anterior tibial compartment syndrome. Clin Orthop 179:284–290

    PubMed  Google Scholar 

  16. Reneman RS (1975) The anterior and the lateral compartmental syndrome of the leg due to intensive use of muscles. Clin Orthop 113:69–80

    PubMed  Google Scholar 

  17. Rorabeck CH, Bourne RB, Fowler PJ (1983). The surgical treatment of exertional compartment syndrome in athletes. J Bone Joint Surg Am 65(9):1245–1251

    CAS  PubMed  Google Scholar 

  18. Schepsis AA, Martini D, Corbett M (1993) Surgical management of exertional compartment syndrome of the lower leg. Long-term followup. Am J Sports Med 21(6):811–817

    CAS  PubMed  Google Scholar 

  19. Slimmon D, Bennell K, Brukner P, Crossley K, Bell SN (2002) Long-term outcome of fasciotomy with partial fasciectomy for chronic exertional compartment syndrome of the lower leg. Am J Sports Med 30(4):581–588

    PubMed  Google Scholar 

  20. Styf J, Korner L, Suurkula M (1987). Intramuscular pressure and muscle blood flow during exercise in chronic compartment syndrome. J Bone Joint Surg Br 69(2):301–305

    CAS  PubMed  Google Scholar 

  21. Turnipseed W, Detmer DE, Girdley F (1989) Chronic compartment syndrome. An unusual cause for claudication. Ann Surg 210(4):557–562

    CAS  PubMed  Google Scholar 

  22. Wallensten R, Eriksson E (1984) Intramuscular pressures in exercise-induced lower leg pain. Int J Sports Med 5(1):31–5

    CAS  PubMed  Google Scholar 

  23. Wiley JP, Clement DB, Doyle LD, Tauton JE (1987) A primary case perspective of chronic compartment syndrome of the leg. Physician Sportsmed 15(3) :111–120

    Google Scholar 

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Correspondence to E. Mouhsine.

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Mouhsine, E., Garofalo, R., Moretti, B. et al. Two minimal incision fasciotomy for chronic exertional compartment syndrome of the lower leg. Knee Surg Sports Traumatol Arthrosc 14, 193–197 (2006). https://doi.org/10.1007/s00167-004-0613-6

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  • DOI: https://doi.org/10.1007/s00167-004-0613-6

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