title: Chronic exertional compartment syndrome of the forearm in elite rowers: a technique for mini-open fasciotomy and a report of six cases.
abstract: Chronic exertional compartment syndrome (CECS) of the forearm may occur in sports requiring prolonged grip strength. CECS is a function of increasing pressure following muscle expansion within an inelastic tissue envelope resulting in compromise of perfusion and tissue function. Typical symptoms are pain, distal paraesthesia and loss of function. The condition is self-limiting and resolves completely between periods of activity. With no effective medical treatment, the gold standard remains four compartment open fasciotomy (Söderberg, J Bone Joint Surg Br 78(5):780-2, 1996; Wasilewski and Asdourian, Am J Sports Med 19(6):665-7, 1991). Minimally invasive techniques have been described (Croutzet et al., Tech Hand Up Extrem Surg 13(3):137-40, 2009) but have a risk of neuro-vascular injury, especially to the ulnar nerve while releasing the deep flexor compartment. We present a safe technique used with six elite rowers for mini-open fasciotomy to minimise scarring and time away from training while reducing the risk of neurovascular injury.
authors.affiliation: Gateshead NHS Foundation Trust, Gateshead, NE9 6SX UK.
authors.forename: John W K
authors.initials: JW
authors.lastname: Harrison
authors.affiliation: Department of Trauma & Orthopaedics, Sunderland Royal Hospital, Sunderland, SR4 7TP UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Thomas
authors.affiliation: Salford Royal Hospitals NHS, Stott Lane, Salford, M6 8HD UK.
authors.forename: Asir
authors.initials: A
authors.lastname: Aster
authors.affiliation: English Institute of Sport, Gateshead International Stadium, Gateshead, NE10 0EF UK.
authors.forename: Graeme
authors.initials: G
authors.lastname: Wilkes
authors.affiliation: Wrightington Hospital, Appley Bridge, Lancashire, WN6 9EP UK.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hayton
keywords: Chronic exertional compartment syndrome; Muscle injury and inflammation; Rowing