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Archives of Orthopaedic and Trauma Surgery

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01-01-2017 | Arthroscopy and Sports Medicine

Single minimal incision fasciotomy for the treatment of chronic exertional compartment syndrome: outcomes and complications

Authors: Michael Drexler, T. Frenkel Rutenberg, N. Rozen, Y. Warschawski, E. Rath, O. Chechik, G. Rachevsky, G. Morag

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2017

Abstract

Introduction

Chronic exertional compartment syndrome (CECS) is a common injury in young athletes, causing pain in the involved leg compartment during strenuous exercise. The gold standard treatment is fasciotomy, but most of the reports on its effectiveness include relatively small cohorts and relatively short follow-up periods. This study reports the long-term results of a large cohort of young athletes who underwent single-incision fasciotomy for CECS.

Materials and methods

This a retrospective case-series study. All patients treated by fasciotomies performed for CECS between 2007 and 2011, in a tertiary medical institution. CECS was diagnosed following history taking and clinical evaluation, and confirmed by compartment pressure measurements. Ninety-five legs that underwent single-incision subcutaneous fasciotomy were included. Data on the numerical analog scale (NAS), Tegner activity score, and quality-of-life (QOL) as measured via the short form-12 (SF-12) were retrieved from all patients preoperatively and at the end of follow-up.

Results

The average time to diagnosis was 22 months and the mean follow-up was 50.1 months. Sixty-three legs underwent anterior compartment fasciotomy (an additional 30 legs also underwent lateral compartment release), and two legs underwent lateral and peroneal compartment releases. The average change in Tegner score was an improvement of 14.6 points. Similarly, the patients reported a significant improvement in the SF-12 and NAS scores. Satisfaction rates were high (average 75.5 %). The main complications were wound infection (2 patients) and nerve injuries (4 patients). Eight patients had recurrence.

Conclusion

Single-incision fasciotomy leads to long-term improvement in the activity level and QOL of patients with CECS.

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Title: Single minimal incision fasciotomy for the treatment of chronic exertional compartment syndrome: outcomes and complications
Authors: Michael Drexler
T. Frenkel Rutenberg
N. Rozen
Y. Warschawski
E. Rath
O. Chechik
G. Rachevsky
G. Morag
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-016-2569-7

At a glance: The STEP trials

Springer Medicine

Single minimal incision fasciotomy for the treatment of chronic exertional compartment syndrome: outcomes and complications

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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