Skip to main content

Advertisement

Log in

Return to activity following fasciotomy for chronic exertional compartment syndrome

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Diagnosis of chronic exertional compartment syndrome (CECS) is relatively rare but has been well documented in athletes. There are, however, few reports regarding return to athletic activity after surgery among elite-level athletes. We hypothesized that a majority of elite-level athletes would successfully return to their previous level of competition following fasciotomy for CECS. A retrospective chart review was performed to identify elite-level athletes (collegiate or professional sport participation) who underwent fasciotomy for CECS over a 3-year period. Data collected included sport or activity, treatment and surgical details, time away from sport/activity after surgery, and ability to return to prior level of activity. Six males and seven females were included in the analysis. Patient age ranged from 17 to 24 years with a mean of 19.7 years. Six patients underwent unilateral lower extremity compartment release, and seven underwent bilateral lower extremity compartment release. The anterior and lateral compartments alone were released in 11 patients (84.6 %). Two patients (15.4 %) underwent four-compartment releases. Eleven patients (84.6 %) were able to return to their previous elite level of sport participation at a mean of 10.6 weeks following surgical fasciotomy. Patients who had four-compartment release had a more than 3.5 week average longer return to full sporting activities (p = 0.011). Fasciotomy is effective in allowing elite athletes with CECS to return to sport.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Barnes M (1997) Diagnosis and management of chronic compartment syndromes: a review of the literature. Br J Sports Med 31:21–27

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Bederka B, Amendola A (2009) Section B. Leg pain and extertional compartment syndrome. Delee and Drez’s Orthopaedic Sports Medicine. Elsevier. http://www.expertconsultbook.com/expertconsult/op/book.do?method=display&eid=4-u1.0-B978-1-4160-3143-7..00024-5-sc2&isbn=978-1-4160-3143-7&decorator=none&type=bookPage. Accessed 27 June 2013

  3. Brown JS, Wheeler PC, Boyd KT, Barnes MR, Allen MJ (2011) Chronic exertional compartment syndrome of the forearm: a case series of 12 patients treated with fasciotomy. J Hand Surg Eur 36:413–419

    Article  CAS  Google Scholar 

  4. Clanton TO, Solcher BW (1994) Chronic leg pain in the athlete. Clin Sports Med 13:743–759

    CAS  PubMed  Google Scholar 

  5. de Fijter WM, Scheltinga MR, Luiting MG (2006) Minimally invasive fasciotomy in chronic exertional compartment syndrome and fascial hernias of the anterior lower leg: short- and long-term results. Mil Med 171:399–403

    PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  7. Edmundsson D, Toolanen G, Sojka P (2007) Chronic compartment syndrome also affects nonathletic subjects: a prospective study of 63 cases with exercise-induced lower leg pain. Acta Orthop 78:136–142

    Article  PubMed  Google Scholar 

  8. Farr D, Selesnick H (2008) Chronic exertional compartment syndrome in a collegiate soccer player: a case report and literature review. Am J Orthop (Belle Mead NJ) 37:374–377

    Google Scholar 

  9. George CA, Hutchinson MR (2012) Chronic exertional compartment syndrome. Clin Sports Med 31:307–319

    Article  PubMed  Google Scholar 

  10. Goubier JN, Saillant G (2003) Chronic compartment syndrome of the forearm in competitive motor cyclists: a report of two cases. Br J Sports Med 37:452–453 (discussion 453–454)

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Hislop M, Tierney P, Murray P, O’Brien M, Mahony N (2003) Chronic exertional compartment syndrome: the controversial “fifth” compartment of the leg. Am J Sports Med 31:770–776

    PubMed  Google Scholar 

  12. 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 10:176–184

    Article  CAS  PubMed  Google Scholar 

  13. Miozzari HH, Gerard R, Stern R, Toman J, Assal M (2008) Acute, exertional medial compartment syndrome of the foot in a high-level athlete: a case report. Am J Sports Med 36:983–986

    Article  PubMed  Google Scholar 

  14. Packer JD, Day MS, Nguyen JT, Hobart SJ, Hannafin JA, Metzl JD (2013) Functional outcomes and patient satisfaction after fasciotomy for chronic exertional compartment syndrome. Am J Sports Med 41:430–436

    Article  PubMed  Google Scholar 

  15. Pedowitz RA, Hargens AR, Mubarak SJ, Gershuni DH (1990) Modified criteria for the objective diagnosis of chronic compartment syndrome of the leg. Am J Sports Med 18:35–40

    Article  CAS  PubMed  Google Scholar 

  16. Raphael BS, Paletta GA Jr, Shin SS (2011) Chronic exertional compartment syndrome of the forearm in a major league baseball pitcher. Am J Sports Med 39:2242–2244

    Article  PubMed  Google Scholar 

  17. Rorabeck CH, Fowler PJ, Nott L (1988) The results of fasciotomy in the management of chronic exertional compartment syndrome. Am J Sports Med 16:224–227

    Article  CAS  PubMed  Google Scholar 

  18. Schepsis AA, Gill SS, Foster TA (1999) Fasciotomy for exertional anterior compartment syndrome: is lateral compartment release necessary? Am J Sports Med 27:430–435

    CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  20. 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 30:581–588

    PubMed  Google Scholar 

  21. Styf J (1988) Diagnosis of exercise-induced pain in the anterior aspect of the lower leg. Am J Sports Med 16:165–169

    Article  CAS  PubMed  Google Scholar 

  22. Styf JR, Korner LM (1986) Chronic anterior-compartment syndrome of the leg. Results of treatment by fasciotomy. J Bone Jt Surg Am 68:1338–1347

    CAS  Google Scholar 

  23. Turnipseed WD (2002) Diagnosis and management of chronic compartment syndrome. Surgery 132:613–617 (discussion 617–619)

    Article  PubMed  Google Scholar 

  24. Tzortziou V, Maffulli N, Padhiar N (2006) Diagnosis and management of chronic exertional compartment syndrome (CECS) in the United Kingdom. Clin J Sport Med 16:209–213

    Article  PubMed  Google Scholar 

  25. Waterman BR, Laughlin M, Kilcoyne K, Cameron KL, Owens BD (2013) Surgical treatment of chronic exertional compartment syndrome of the leg: failure rates and postoperative disability in an active patient population. J Bone Jt Surg Am 95:592–596

    Article  Google Scholar 

  26. Wittstein J, Moorman CT III, Levin LS (2010) Endoscopic compartment release for chronic exertional compartment syndrome: surgical technique and results. Am J Sports Med 38:1661–1666

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors of the present manuscript declare that they have not proprietary interest or conflict of interest. The authors of the present manuscript, Val Irion, Robert A. Magnussen, Timothy L. Miller, and Christopher C. Kaeding, declare that they have no proprietary interest or conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christopher C. Kaeding.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Irion, V., Magnussen, R.A., Miller, T.L. et al. Return to activity following fasciotomy for chronic exertional compartment syndrome. Eur J Orthop Surg Traumatol 24, 1223–1228 (2014). https://doi.org/10.1007/s00590-014-1433-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-014-1433-0

Keywords

Navigation