Fasciotomy for Lateral Lower-leg Chronic Exertional Compartment Syndrome

• Published in: International journal of sports medicine 2018-12, Vol.39 (14), p.1081-1087
• Main Authors: van Zantvoort, Aniek Philomena Maria, de Bruijn, Johan Anthonius, Hundscheid, Henricus P. H., van der Cruijsen-Raaijmakers, Marike, Teijink, Joep A. W., Scheltinga, Marc R.
• Format: Article
• Language: English
• Subjects: Clinical Sciences
• ISSN: 0172-4622; 1439-3964
• DOI: 10.1055/a-0640-9104

Abstract Exercise-induced lower leg pain may be caused by chronic exertional compartment syndrome (CECS). Anterior or deep posterior compartments are usually affected. Knowledge about CECS of the lateral compartment (lat-CECS) is limited and outcome after fasciotomy is unknown. The purpose of this study is to report on success rates of fasciotomy in patients with lat-CECS. Surgical success rates in patients with lat-CECS diagnosed with a dynamic intracompartmental pressure (ICP) measurement were studied using a questionnaire (success: excellent or good as judged by the patient; unsuccessful: moderate, fair or poor). We conducted ICP measurements in 247 patients for suspected lat-CECS, of whom 78 were positively diagnosed. Following exclusion (n=11), 30 of the eligible 67 patients completed the questionnaire. Bilateral (70%, n=21/30) exertional pain (97%, n=29) and a feeling of tightness (93%, n=28) were the most frequently reported symptoms. Four years after fasciotomy, severity and frequency of symptoms had dropped significantly. Long-term surgical success was reported by 33% (n=10; excellent n=4, good n=6). Seventy-three percent (n=22) had resumed sports activities (9 same level, 13 lower level). In conclusion, a fasciotomy for lat-CECS was successful in the long term in just one of three operated patients in this retrospective study.