title: Return to duty after elective fasciotomy for chronic exertional compartment syndrome.
abstract: BACKGROUND
  Civilian literature has reported excellent outcomes after elective fasciotomy for chronic exertional compartment syndrome (CECS). Our study's purpose was to objectively investigate the functional outcome of fasciotomies performed for CECS in a high demand military population.
  
  
  METHODS
  A retrospective review of all fasciotomies performed for CECS at a single tertiary military medical center was performed. The primary outcome measure was the ability to return to full active duty. Diagnosis, operative technique, and number of compartments addressed were collected and analyzed. Patients were contacted and the visual analog scale (VAS) pain score, functional single assessment numeric evaluation (SANE) score, as well as overall satisfaction were reported. Return to duty status was collected on 70 of 70 (100%) consecutive operative extremities in 46 patients with an average follow-up of 26 months.
  
  
  RESULTS
  Only 19 patients (41.3%) were able to return to full active duty. Ten patients (21.7%) underwent a medical separation from the military and 17 patients (37%) remained in the military but were on restricted duty secondary to persistent leg pain. Thirty-five of 46 (76%) of the patients were contacted and provided subjective feedback. The average SANE score was 72.3, and there was a mean improvement of 4.4 points in VAS score postoperatively. Overall, 71% of patients were satisfied and would undergo the procedure again. Outcomes were correlated to operative technique, patient rank, and branch of military service.
  
  
  CONCLUSIONS
  Our study showed a return to full military duty in 41% of patients who underwent elective fasciotomy for CECS. Overall 78% of patients remained in the military, which is consistent with previous military literature. Subjective satisfaction rate was 71%. Both the return to activity and subjective outcomes in our study population were substantially lower than reported results in civilian populations.
  
  
  METHODS
  Level IV, case series.
authors: Tripler Army Medical Center, Honolulu, HI, USA jeremy.r.mccallum@us.army.mil.
authors: Jeremy R
authors: JR
authors: McCallum
authors: Tripler Army Medical Center, Honolulu, HI, USA.
authors: Jay B
authors: JB
authors: Cook
authors: Tripler Army Medical Center, Honolulu, HI, USA.
authors: Adam C
authors: AC
authors: Hines
authors: Tripler Army Medical Center, Honolulu, HI, USA.
authors: James S
authors: JS
authors: Shaha
authors: Walter Reed NMMC, Bethesda, MD, USA.
authors: Jefferson W
authors: JW
authors: Jex
authors: Tripler Army Medical Center, Honolulu, HI, USA.
authors: Joseph R
authors: JR
authors: Orchowski
mesh_terms: D000328:Adult; D003161:Compartment Syndromes / Q000503:physiopathology / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006772:Hospitals, Military; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D009784:Occupational Diseases / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D005082:Physical Exertion / Q000502:physiology*; D011183:Postoperative Complications; D012189:Retrospective Studies; D062707:Return to Work / Q000706:statistics & numerical data*; D014481:United States; D064232:Visual Analog Scale; D055815:Young Adult
keywords: chronic exertional compartment syndrome; functional outcome; lower extremity; sports medicine