title: Endoscopic decompression for chronic compartment syndrome of the forearm in motocross racers.
abstract: OBJECTIVE
  Sporting activities that involve repetitive stress to muscle compartments can elicit chronic exertional compartment syndrome. Its occurrence in the lower leg muscle compartments is most common, but other locations are less well known and the pathophysiology is not completely understood. In motocross racers, chronic exertional compartment syndrome can occur in the muscles of the lower arm. Currently, the only accepted treatment of correctly diagnosed chronic exertional compartment syndrome is surgical release of the fascia, which successfully relieves pain and allows patients to return to full activity. Open decompression is considered as the gold standard of treatment. This clinical paper describes our new endoscopic technique and investigates the functional outcome after surgery.
  
  
  METHODS
  We report on a series of 154 chronic exertional compartment syndromes afflicted motocross racers treated with an endoscopic release of the lower arm muscles. An MRI scan before and after strenuous exercise of the hand flexors (repetitive grip until exhaustion for 15 min) was performed to confirm the clinical diagnosis of chronic exertional compartment syndrome. Symptom severity before and after surgery was assessed using a visual analogue scale.
  
  
  RESULTS
  Preoperative symptom severity scores were 1.1 ± 0.3 before exercise and 7.4 ± 1.5 after exercise. Post-operatively, these were 1.0 ± 0.2 and 1.7 ± 0.9. The pre- versus post-operative symptom scores after exercise were significantly different (p < 0.0001). No perioperative complications occurred, and at 6 weeks, all of the racers resumed their sportive activities.
  
  
  CONCLUSIONS
  It can be concluded that endoscopic release of the superficial compartment of the forearms of motocross racers diagnosed with chronic exertional compartment syndrome is a valuable treatment option, with mild post-operative pain and fast recovery.
authors.affiliation: Ziekenhuis Netwerk Antwerpen, Lange Beeldekensstraat 267, 2060, Antwerp, Belgium, christophe.jans@gmail.com.
authors.forename: Christophe
authors.initials: C
authors.lastname: Jans
authors.forename: Geert
authors.initials: G
authors.lastname: Peersman
authors.forename: Benjamin
authors.initials: B
authors.lastname: Peersman
authors.forename: Tom
authors.initials: T
authors.lastname: Van Den Langenbergh
authors.forename: Jody
authors.initials: J
authors.lastname: Valk
authors.forename: Tom
authors.initials: T
authors.lastname: Richart
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003161:Compartment Syndromes / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012090:Cumulative Trauma Disorders / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy; D000071938:Fasciotomy; D005260:Female; D005543:Forearm Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009049:Motorcycles; D016896:Treatment Outcome; D055815:Young Adult