title: Minimally invasive fasciotomy in chronic exertional compartment syndrome and fascial hernias of the anterior lower leg: short- and long-term results.
abstract: This study evaluated the efficacy of a minimally invasive percutaneous fasciotomy in chronic exertional compartment syndrome and fascial hernias of the anterior lower leg (N = 118). Approximately one-third of symptomatic legs (n = 41) demonstrated fascial herniation and underwent fasciotomy without compartment pressure measurements via a small percutaneous incision using a fasciotome. Symptomatic legs with an intact fascia (n = 77) received similar operative treatment based on pressure measurements. Relief of symptoms was obtained in all but two patients. Postoperative complications included hematoma (9%), superficial peroneal nerve injury (2%), anterior ankle pain (5%), and recurrence (2%). Most patients (96%) reported unlimited exercise after a mean follow-up of 62 months. However, mild symptoms associated with nerve injury as well as ankle pain persisted (4%). A minimally invasive fasciotomy of the anterior lower leg harboring fascial hernias or a chronic exertional compartment syndrome is effective. Complications such as nerve injury and anterior ankle pain may be related to a too distally performed fasciotomy.
authors.affiliation: Department of Surgery, Maxima Medical Center, Veldhoven, The Netherlands.
authors.forename: Wijand Marnixde
authors.initials: WM
authors.lastname: de Fijter
authors.forename: Marcus Reinoud
authors.initials: MR
authors.lastname: Scheltinga
authors.forename: Martinus G
authors.initials: MG
authors.lastname: Luiting
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000868:Anterior Compartment Syndrome; D005205:Fascia / Q000503:physiopathology; D000071938:Fasciotomy; D005260:Female; D059685:Herniorrhaphy; D006801:Humans; D007866:Leg; D008297:Male; D008485:Medical Audit; D019060:Minimally Invasive Surgical Procedures; D016896:Treatment Outcome; D014481:United States