Anatomic structures at risk during minimal-incision endoscopically assisted fascial compartment releases in the leg.
BACKGROUND
Although minimal-incision surgical techniques are recommended for treatment of chronic exertional compartment syndrome of the leg, which is an increasing problem among endurance athletes, there is little information about anatomic correlation with structures at risk.


OBJECTIVE
Fascial releases performed with endoscopic assistance are safer than the percutaneous method.


METHODS
Controlled laboratory study.


METHODS
Ten endoscopically assisted and six percutaneous fascial releases were performed on 16 human cadaveric lower limbs. Formal dissection documented length of release and proximity of structures at risk.


RESULTS
Endoscopically assisted fascial release led to reduced risk of superficial peroneal nerve injury compared with a blind percutaneous release through a 2- to 3-cm incision. Both techniques had unacceptable rates of saphenous vein injury (30% to 100%), and releases performed percutaneously had greater length.


CONCLUSIONS
Risk of superficial peroneal nerve injury was less with single-incision endoscopically assisted fascial release. Risk of injury to the saphenous vein from either technique appeared to be unacceptable.


CONCLUSIONS
Single-incision endoscopically assisted fascial release of the anterior and lateral compartments may be a useful technique with low risk of peroneal nerve injury. Clinical studies will confirm whether this technique proves safer or more effective than those currently used for chronic exertional compartment syndrome of the leg.
Hutchinson
Mark R
MR
Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, USA.
Bederka
Bryce
B
Kopplin
Matthew
M
D002102:Cadaver; D003161:Compartment Syndromes / Q000601:surgery*; D004724:Endoscopy / Q000009:adverse effects*; D005205:Fascia / Q000473:pathology; D000071938:Fasciotomy; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects*; D010543:Peroneal Nerve / Q000293:injuries*; D011183:Postoperative Complications; D012307:Risk Factors; D012501:Saphenous Vein / Q000293:injuries