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Chronic exertional compartment syndrome of the leg

Current Reviews in Musculoskeletal Medicine volume 3, pages 32–37 (2010)Cite this article

Abstract

Chronic exertional compartment syndrome (CECS) is an underdiagnosed cause of chronic exertional leg pain. The syndrome most commonly occurs in young adult recreational runners, elite athletes, and military recruits. CECS is caused by increased intracompartmental pressure within a fascial space; however, the mechanism of why pain occurs is unknown. Symptoms are classically pain in the affected compartment at the same time, distance, or intensity of exercise. CECS is a clinical diagnosis; however, it is confirmed by intracompartmental pressure testing. Fasciotomy is the treatment of choice for athletes who would like to maintain the same level of activity. Athletes who have a release of the anterior and lateral compartments have a high success rate.

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References

  1. Amendola A, Rorabeck CH, et al. The use of magnetic resonance imaging in exertional compartment syndromes. Am J Sports Med. 1990;18(1):29–34.

    CAS  Article  PubMed  Google Scholar 

  2. Barnes M. Diagnosis and management of chronic compartment syndromes: a review of the literature. Br J Sports Med. 1997;31(1):21–7.

    CAS  Article  PubMed  Google Scholar 

  3. Blackman PG. A review of chronic exertional compartment syndrome. Med Sci Sports Exerc. 2000;32:4–10.

    Article  Google Scholar 

  4. Bong M, Polatsch D, Jazrawi L, et al. Chronic exertional compartment syndrome: diagnosis and management. Hosp Joint Dis. 2005;62:77–84.

    Google Scholar 

  5. Brennan F, Kane S. Diagnosis, treatment options, and rehabilitation of chronic lower leg exertional compartment syndrome. Curr Sport Med Rep. 2003;2:247–50.

    Google Scholar 

  6. Brown R, Rosenberg Z. MR imaging of exercise-induced lower leg pain. Magn Reson Imaging Clin N Am. 2001;9(3):544–7.

    Google Scholar 

  7. Canale S. Campbell’s operative orthopaedics. 9th ed. Philadelphia: Elsevier; 1998. p. 405–1411.

    Google Scholar 

  8. Cook S, Bruce G. Fasciotomy for chronic compartment syndrome in the lower limb. ANZ J Surg. 2002;72(10):720–3.

    Article  PubMed  Google Scholar 

  9. Coughlin M, Mann R, Saltzman CL. Surgery of the foot and ankle. Philadelphia: Elsevier; 2007. p. 1438–44.

    Google Scholar 

  10. DeLee JC, et al. DeLee and Drez’s orthopaedic sports medicine. Philadelphia: Saunders; 2003. p. 2163–70.

    Google Scholar 

  11. Edwards P, Myerson M. Exertional compartment syndromes of the leg. The Institute for Foot and Ankle Reconstruction. www.footandankle.mdmercy.com/research_pubs/pressItem37.html. Accessed 5 July 1995.

  12. Englund J. Chronic compartment syndrome: tips on recognizing and treating. J Fam Pract. 2005;54(11):955–60.

    PubMed  Google Scholar 

  13. Frontera W. Essentials of physical medicine and rehabilitation. Canada: Hanley and Belfus; 2002. p. 256–61.

    Google Scholar 

  14. Goldfarb S, Kaeding C. Bilateral acute-on-chronic exertional lateral compartment syndrome of the leg: a case report and review of the literature. Clin J Sports Med. 1997;7:59–62.

    CAS  Article  Google Scholar 

  15. Hayes AA, Bower GD, Pitstock KL. Chronic exertional compartment syndrome of the legs diagnosed by thallious chloride scintigraphy. J Nuc Med. 1995;36(9):1618–24.

    CAS  Google Scholar 

  16. Howard J, Mohtadi N, Wiley J. Evaluation of outcomes in patients following surgical treatment of chronic exertional compartment syndrome in the leg. Clin J Sports Med. 2000;10:176–84.

    CAS  Article  Google Scholar 

  17. Humphries D. Exertional compartment syndromes. Medscape Gen Med. 1999;3:1–7. http://www.medscape.com/viewarticle/408500. Accessed 5 April 1999.

  18. Hutchinson M, Bederka B, Kopplin M. Anatomic structures at risk during minimal-incision endoscopically assisted fascial compartment releases in the leg. Am J Sports Med. 2003;5:764–9.

    Google Scholar 

  19. Illig K, Uriel K, De Weese J, et al. Case report: a condemnation of subcutaneous fasciotomy. Mil Med. 1998;163(11):794–6.

    CAS  PubMed  Google Scholar 

  20. Kitajima I, Tachibana S, Hirota Y, et al. One-portal technique of endoscopic fasciotomy: chronic compartment syndrome of the lower leg. Arthroscopy. 2001;17(8):1–3.

    Article  Google Scholar 

  21. Leversedge F, Casey P, Seiler J, Xerogeanes J. Endoscopically assisted fasciotomy: description of technique and in vitro assessment of lower-leg compartment decompression. Am J Sports Med. 2002;30(2):272–8.

    PubMed  Google Scholar 

  22. Matsen F, Winquist R, Krugmire R. Diagnosis and management of compartmental syndromes. J Bone Joint Surg. 1980;62:286–91.

    PubMed  Google Scholar 

  23. 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. 2006;14:193–7.

    CAS  Article  PubMed  Google Scholar 

  24. Ota Y, Senda M, Hashizume H, et al. Chronic compartment syndrome of the lower leg. Arthroscopy. 1999;15(4):439–43.

    CAS  Article  PubMed  Google Scholar 

  25. Raikin S, Venkat R, Vitanzo P. Bilateral simultaneous fasciotomy for chronic exertional compartment syndrome. Foot Ankle Int. 2005;26:1007–11.

    PubMed  Google Scholar 

  26. Rowden G. Compartment syndromes. Emedicine. http://www.emedicine.com/SPORTS/topic26.html. Accessed 30 Nov 2006.

  27. Scheltinga MR. Minimally invasive fasciotomy in chronic exertional compartment syndrome and fascial hernias of the anterior lower leg: short and long term results. Mil Med. 2006;171:399–403.

    PubMed  Google Scholar 

  28. Shah S, Miller B, Kuhn J. Chronic exertional compartment syndrome. Am J Orthop. 2004;33(7):335–41.

    PubMed  Google Scholar 

  29. Simon R, Sherman S, Koenigsknecht S. Compartment syndrome. Emergency orthopedics: the extremities. New York: McGraw Hill; 2007. p. 76–8, 441–3.

  30. Trease L, Every B, Bennell K, et al. A prospective blinded evaluation of exercise thallium-201 SPET in patients with suspected chronic exertional compartment syndrome of the leg. Eur J Nucl Med. 2001;28(6):688–95.

    CAS  Article  PubMed  Google Scholar 

  31. Tzortziou V, Maffulli N, Padhiar N. Diagnosis and management of chronic exertional compartment syndrome in the United Kingdom. Clin J Sports Med. 2006;16(3):209–13.

    Article  Google Scholar 

  32. Verleisdonk E, Schmitz R, Van der Werken C. Long term results of fasciotomy of the anterior compartment in patients with exercise-induced pain in the lower leg. Int J Sports Med. 2004;25:224–9.

    CAS  Article  PubMed  Google Scholar 

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  1. Christiana Care Health System, 1401 Foulk Rd., Suite 100-B, Wilmington, DE, 19803, USA

    Alicia K. Tucker

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  1. Alicia K. Tucker
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Tucker, A.K. Chronic exertional compartment syndrome of the leg. Curr Rev Musculoskelet Med 3, 32–37 (2010). https://doi.org/10.1007/s12178-010-9065-4

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Keywords

  • Compartment syndrome
  • Lower extremity
  • Fasciotomy
  • Chronic leg pain